Prostate Artery Embolization (PAE) is a minimally invasive procedure designed to address benign prostatic hyperplasia (BPH), a common condition where the prostate gland enlarges. This treatment aims to reduce the prostate’s size by restricting its blood supply, thereby alleviating urinary symptoms. This article outlines common, less frequent, and rare post-procedure effects.
Expected Post-Procedure Symptoms
Many patients experience Post-Embolization Syndrome (PES) after PAE. This syndrome typically includes mild to moderate pelvic pain or discomfort, which can often be managed effectively with over-the-counter pain relievers such as ibuprofen or acetaminophen.
Temporary increases in urinary frequency, burning, or pressure are common. Patients might also experience flu-like symptoms, including a low-grade fever, fatigue, or chills, which are a natural response to the body’s reaction to the treated prostatic tissue.
It is also normal to observe a small amount of blood in the urine or semen for a few days to a week after the procedure. PES symptoms usually begin within 48 hours and typically resolve within a week.
Occasionally, the prostate gland may swell slightly in the days following PAE, potentially causing a temporary worsening of pre-existing lower urinary tract symptoms. This swelling is often managed with a short course of steroid medication.
Less Frequent Reactions
Beyond common post-embolization symptoms, some patients may experience less frequent reactions. Temporary urinary retention, an inability to urinate, can occur, though its incidence varies and it may sometimes necessitate temporary catheterization.
Mild bladder spasms are another less common symptom. These issues are generally short-lived as the prostate begins to shrink and the body adjusts to the changes.
The catheter insertion site, typically in the groin or wrist, may exhibit minor skin irritation, tenderness, or bruising. This localized discomfort usually subsides within a few weeks.
Some men may experience temporary erectile dysfunction or scrotal pain and inflammation, though these occurrences are generally rare and often resolve without specific intervention. Retrograde ejaculation, where semen enters the bladder during orgasm, is also a reported reaction, but it is considerably less common after PAE than following more invasive surgical procedures for BPH. Urinary tract infections (UTIs) are a known, albeit rare, complication, reported in about 2% to 8% of cases, and can typically be treated with antibiotics.
Serious Potential Risks
While PAE is generally considered safe, patients should be aware of certain serious, though rare, potential risks. One such risk is non-target embolization, which occurs when the embolic particles inadvertently travel to arteries supplying organs other than the prostate, such as the bladder, rectum, or skin.
This can lead to localized tissue damage or complications like bladder wall ischemia, which may require surgical repair. Rectal pain or bleeding can also occur if particles reach the rectal arteries, though this is usually temporary.
Similarly, rare cases of penile skin lesions or temporary erectile dysfunction have been linked to non-target embolization to penile arteries. The risk of non-target embolization is minimized by the expertise of the interventional radiologist and the use of advanced imaging techniques during the procedure.
Infection is another infrequent but serious concern; a prostate abscess is exceedingly rare after PAE. Infections can occur at the puncture site or as a urinary tract infection.
Severe hemorrhage or bleeding is also a rare complication, reported in about 1% to 5% of patients. Rarely, blood clots may form during or shortly after the procedure.
Additionally, some individuals may experience an allergic reaction to the contrast dye used during the procedure, which can be managed if disclosed to the healthcare provider beforehand.
Navigating Recovery and Concerns
Recovery after Prostate Artery Embolization involves adhering to specific guidelines and monitoring your body’s signals. It is advisable to rest and stay well-hydrated in the initial days following the procedure.
Pain management can typically be achieved with over-the-counter medications as directed by your physician. Most patients can resume light daily activities and return to work within a few days to a week, but avoid strenuous activities, heavy lifting, and sexual activity for at least one week to allow for proper healing.
It is important to contact your healthcare provider if you experience any concerning or unexpected symptoms during your recovery. Seek medical attention for severe or worsening pain that is not relieved by medication, a persistent high fever (above 101.5 degrees Fahrenheit or 38.6 degrees Celsius), or an inability to urinate beyond temporary retention.
Signs of infection at the catheter insertion site, such as increasing redness, swelling, or discharge, also warrant immediate medical consultation. Any excessive bleeding or a growing lump at the puncture site should also be reported promptly.
Regular follow-up appointments with your medical team are also important to monitor your progress and address any ongoing concerns.