Prostate Artery Embolisation (XR361)
What is Artery Embolisation?
Prostate embolisation is a minimally-invasive non-surgical procedure used to treat enlarged prostate by blocking off the arteries that feed the gland and making it shrink. The procedure is performed under local anaesthetic.
Why this procedure
Prostate embolisation for enlarged prostate gland (benign prostatic hyperplasia (BPH)) is a new procedure which is considered when other forms of treatment are deemed unsuitable or high risk.
What is the procedure
A fine, flexible plastic tube about as thick as a spaghetti strand (catheter) is inserted into an artery in your groin. Using x-ray monitoring to check its position, the catheter is guided into both your prostate arteries (right and left). A special X-ray dye, called contrast medium, is injected down the catheter into these prostate arteries, and this may give you a hot feeling in the pelvis. Once the prostate blood supply has been identified and only when the catheter is precisely positioned is the fluid containing the tiny particles injected, through the catheter. This flows into the prostate arteries and blocks them off.
The particles are made from a plastic-like material called polyvinyl alcohol and are about the size of grains of sand. They will remain in your body permanently. In over 30 years of use, they have not shown any harmful effects.
Both the right and the left prostatic arteries need to be blocked in this way. It can often all be done from the right groin, but sometimes it may be difficult to block the branches of the left prostatic artery from the right groin, and so a needle and catheter needs to be inserted into the left groin as well.
Before, during and after the procedure
You do not need to have a general anaesthetic, but you will be given a sedative, which will relax you and make you feel sleepy. You will be given a local anaesthetic in your right groin; the area may also be shaved and sterilised. The procedure can take up to two hours.
Once the embolisation is completed, the catheter is taken out and pressure is applied to the puncture site in your groin for about ten minutes to stop bleeding. You should not need any stitches or dressings.
Very rarely there is a chance that small particles can lodge in the wrong place and deprive normal tissue of its oxygen supply. In an attempt to avoid these complications, close attention is paid to the pattern of the blood vessels in the pelvis, noting that the path of the vessels can be different in each individual. Despite this there is a very small risk of injury to the bladder, rectum and genitals because of their close proximity to the prostate.
Occasionally patients may have an allergic reaction to the x-ray contrast dye used during prostate embolisation. These episodes range from mild itching to severe reactions that can affect breathing or blood pressure. Patients undergoing prostate embolisation are carefully monitored during the procedure, so that any allergic reaction can be detected and treated immediately. There is also the very slight possibility that the procedure will fail due to an inability to embolise the arteries completely.