Prostate embolisation

Benign prostatic hyperplasia (BPH), also known as prostate adenoma, is an enlargement of the prostate, a gland located just below the bladder in men. As men get older, the prostate tends to grow larger, which can lead to compression of the urethra (the tube that carries urine from the bladder out of the body).

• Frequent need to urinate, especially at night (nocturia)
• Difficulty starting to urinate
• Weak or interrupted urine stream
• Feeling that the bladder has not been completely emptied
• Urgent need to urinate (urgency)
• Urinary leakage

1. Preparation: Before the procedure, you will have a consultation with the interventional radiologist to discuss your medical history, your medication, and the risks and benefits of embolisation. Imaging tests (MRI, CT scan) will be carried out to assess the size and blood supply of your prostate.
2. Anaesthesia: Prostate embolisation is usually carried out under local anaesthesia with light sedation to help you relax.
3. Vascular access: The interventional radiologist inserts a thin catheter (tube) into an artery in the groin or arm (femoral or radial approach).
4. Guidance: Using real-time imaging (X-ray), the catheter is guided to the arteries that supply the prostate (prostatic arteries).
5. Embolisation: Tiny particles (known as embolic agents) are injected through the catheter to block the prostatic arteries. This reduces the blood supply to the prostate, leading to a reduction in its volume.
6. Catheter removal: Once the embolisation is complete, the catheter is removed and a pressure dressing is applied to the insertion site.

• Less invasive: No surgical incision, which means less pain, fewer complications and a quicker recovery than with surgical procedures.
• Preservation of sexual function: Prostate embolisation carries a low risk of adversely affecting erectile function and ejaculation, unlike some surgical options.
• Symptom relief: Reduced urinary frequency, improved urine flow and reduced urinary urgency.
• An alternative for patients at high surgical risk: It is an alternative for men who are not suitable candidates for surgery due to health problems or the risks associated with anaesthesia
• Can be repeated: If symptoms recur over time, the embolisation can be repeated.

Like any medical procedure, prostate embolisation carries certain risks and potential side effects, including:

• Pain: Pain in the pelvis or groin area, which is usually managed with painkillers.
• Bruising or swelling: At the site where the catheter was inserted.
• Infection: Rare, but possible.
• Haematuria: Blood in the urine (rare and temporary).
• Haemospermia: Blood in the semen (rare and temporary).
• Urinary retention: Difficulty urinating, sometimes requiring a temporary urinary catheter (rare).
• Procedural failure: In some cases, embolisation may not be technically feasible (vascular tortuosity) or may not result in a significant improvement in symptoms (insufficient embolisation).
• Very rare complications: More serious complications, such as arterial damage or ischaemia of other organs, are very rare.

Following the embolisation, you will be closely monitored. Most patients are able to go home either on the same day or the following day. Pain relief will be prescribed. A follow-up appointment will be arranged to assess the effectiveness of the treatment and monitor for any side effects.

Prostate embolisation can be an excellent option for men with BPH who are looking for a less invasive alternative to surgery. However, it is essential to discuss your treatment options with your doctor to determine whether prostate embolisation is the best option for you, taking into account your general state of health, the severity of your symptoms and your personal preferences.