Section of Vascular and Interventional Radiology

Section of Vascular and Interventional Radiology

 

Prostate Artery Embolization (PAE):

A new treatment to relieve the obstructions from enlarged prostate glands.

The prostate gland is part of the male reproductive system. It is situated at the base of the urinary bladder surrounding the bladder empting conduit for urination, the urethra.  As a man age, the prostate gland enlarges. It may press on the urethra and obstruct the urine flow.

 

BPH

 

Benign Prostate Hypertrophy (BPH) refers to the enlarged prostate gland and is the most common cause of Lower Urinary Track Symptoms (LUTS) in older males. The most common symptoms are:

  1. Frequent urination, especially problematic at night
  2. A hesitant, interrupted, or weak stream of urine
  3. Leaking or dribbling of urine, as the bladder remains overfilled attempting to empty
  4. Feeling as though the bladder is not empty even after urination
  5. Repeated or non-resolving urinary tract infections, as contaminated urine remains retained in the bladder

Mild symptoms from BPH might require just some lifestyle changes like

  1. avoid drinking fluids after certain hour
  2. avoid ingesting products with diuretic effect like caffeine oralcohol
  3. double void, as wait a moment after urination and try  for a second time

Moderate to Severe symptoms from BPH frequently require medical treatments.
The medicines used to relieve LUTS from BPH are drugs that relax muscles that are normally responsible for urine continence at the base of the bladder outlet (Flomax, Hytrin, Cardura, Uroxatral, Rapaflo) to compensate for the obstruction effects. Other used drugs reduce the size of the prostate by blocking the male hormones that stimulate the gland growth (Finasteride, Dutasteride). 
Therapeutic interventions are considered when drugs fail to resolve the BPH problems. Trans-Urethral Resection of the Prostate (TURP) is a procedure commonly performed by Urologists where prostate portions are resected using special instruments inserted through the penis urethral meatus.
Prostate Artery Embolization (PAE) is a procedure performed by Interventional Radiologists (IR) where the prostate size is reduced by blocking its arterial blood supply (embolization).

vascular access

 

 

PAE is performed through a single needle puncture at the upper thigh/hip, or at the forearm wrist area.

prostate artery selection

micro catheter Through this puncture, a minuscule duct (micro-catheter) is used to release microscopic particles at the arterial branches that supply the prostate gland with blood (embolization).

 

 

embolized prostate

The oxygen and nutrition restriction from the embolization results in shrinkage of the prostate tissue relieving obstruction of urine flow.
PAE is an ambulatory procedure which means that most patients go home and do not have to spend a night at hospital. The procedure recovery is fast and most patients resume their routine lifestyle by next day.

 

To schedule an appointment please call:
Perla Williams 210 358 2373

Otilia Merjil 210 3580420

 

 

Uterine Artery Embolization (UAE) or Uterine Fibroid Embolization (UFE):
Uterine fibroids are the most common tumor found in women. Approximately 25% of premenopausal women suffer from fibroids. Medical treatment of the uterine fibroids using Gonadotropin Releasing Hormone Analogue such as Lupron, has been employed in some cases; however, its effect to reduce the fibroid size is reversible (Fibroid increase in size again after stopping the medication). Surgery is another treatment option and the presence of symptomatic fibroids is the most common indication for hysterectomy (Uterine removal).  Myomectomy is another surgical treatment option that leaves the uterus in place and may therefore preserve the fertility. Currently, uterine fibroid embolization (UFE) is a well-established minimal invasive treatment for symptomatic uterine fibroids.

 


Schematic of the various locations of fibroids within the uterus:
Submucosal fibroids indent into the uterine cavity.
Intramural fibroids are located within the wall of the uterus.
Subserosal fibroids extend from the surface of the uterus.

  • Prolonged and intensive cyclical menstrual bleeding (Heavy monthly period) is the most frequent clinical presentation of submucosal fibroids.
  • Bulk symptoms are usually caused by subserosal fibroids that compress the nearby pelvic structures, resulting in the associated symptoms of pain, urinary frequency and constipation.
  • Uterine fibroids may impact fertility usually due to a submucosal fibroid distorting the endometrial cavity. 

 
Uterine Artery Embolization (UAE) is a procedure performed by Interventional Radiologists (IR) where the fibroid size is reduced by blocking its arterial blood supply (embolization).
UAE is performed by a single needle stick at the wrist or the groin. Through this puncture, a minuscule duct (micro-catheter) is used to release microscopic particles at the arterial branches that supply the fibroid with blood, blocking the blood supply to the fibroid and consequently shrinking the fibroid.

Uterine artery embolization is a minimal invasive procedure to treat uterine fibroids with comparable results to surgery and faster recovery time. 


To schedule an appointment please call:
Perla Williams 210 358 2373

Otilia Merjil 210 3580420