Are you experiencing changes in your urinary habits? Perhaps you’re waking up multiple times at night to use the bathroom or finding it difficult to start urinating. Maybe you feel like you can never quite empty your bladder completely, or you’re dealing with a sudden, urgent need to urinate. You’re not alone. These symptoms affect millions of men, particularly as they age, and can significantly impact your quality of life. Two common conditions that can cause these symptoms are benign prostatic hyperplasia (BPH) and an overactive bladder (OAB).
Understanding Your Urinary System
To understand what’s happening, let’s first talk about how your urinary system works. Your bladder is like a sophisticated storage tank designed to hold urine until it’s convenient to empty it. When working correctly, your bladder sends signals to your brain when it’s getting full, giving you plenty of time to find a bathroom. The urine then flows from your bladder through a tube called the urethra, which passes through your prostate gland before exiting through your penis.
The prostate plays a crucial role in this system. It’s normally about the size of a walnut and sits just below your bladder. While its main job is to produce fluid for semen, its location around the urethra means that any changes in its size can affect your urinary flow.
What’s Causing Your Symptoms?
Urinary symptoms can be complex because they often have overlapping causes, benign prostatic hyperplasia (BPH) and an overactive bladder (OAB).
BPH occurs when your prostate naturally enlarges with age. As it grows, it can squeeze the urethra, making it harder for urine to flow, like pinching a garden hose. This pressure can also irritate your bladder, causing it to become more sensitive and contract even when it’s not full.
One of the most challenging aspects of urinary symptoms is that they can have multiple causes working together. For example, while BPH might be the main issue, your bladder may also be overactive (a condition called OAB), causing sudden, strong urges to urinate. The relationship between these conditions is complex – sometimes, the enlarged prostate irritates the bladder, causing it to become overactive. In other cases, they may be separate conditions occurring simultaneously.
What makes this particularly tricky is that even with modern testing and imaging, it’s often impossible to determine beforehand exactly how much of your symptoms are caused by the enlarged prostate versus bladder issues. This is why it’s important to understand that while Prostate Artery Embolization (PAE) is highly effective for most men (85-90% see significant improvement), about 10-15% of patients may not experience the level of improvement they hoped for, even when the procedure is technically successful. This usually occurs because their symptoms are more related to bladder issues than to their enlarged prostate.
We share this information to help you make an informed decision about your treatment. During your consultation, discuss your specific symptoms and circumstances in detail, helping you understand the likelihood of improvement in your particular case.
The Impact on Your Life
Living with urinary symptoms isn’t just physically uncomfortable – it can affect every aspect of your life. Many men plan their activities around bathroom availability, avoiding long trips or missing out on social events. Interrupted sleep from nighttime bathroom visits can leave you tired and irritable during the day. Some men even experience anxiety or embarrassment about their symptoms, which can affect their relationships and social confidence.
Understanding Your Treatment Options
When it comes to treating these urinary symptoms, you have several options. Many men start with medications, which can help relax the prostate and bladder muscles or even shrink the prostate over time. While medications work for some men, others find the side effects challenging or see limited improvement in their symptoms.
Traditional surgical options have typically involved removing or cutting away prostate tissue through the urethra. While these surgeries can be effective, they often require general anesthesia and a hospital stay and carry risks of complications that can affect your quality of life, including sexual function.
Several minimally invasive surgical treatments (MISTs) are available for benign prostatic hyperplasia. These include:
- Prostatic Urethral Lift (UroLiftTM): A procedure that uses small implants to lift and hold the enlarged prostate tissue away from the urethra.
- Water Vapor Therapy (Rezūm): Uses steam to destroy excess prostate tissue.
- Holmium Laser Enucleation (HoLEP): Removes excess prostate tissue using a laser.
- Transurethral Resection of the Prostate (TURP): A scope is inserted through the urethra to help a surgeon see and trim away excess tissue.
- Prostate Artery Embolization (PAE): Targets excess tissue using advanced imaging guidance
Prostate Artery Embolization
We’re proud to offer a revolutionary alternative: Prostate Artery Embolization (PAE). This procedure represents a completely different approach to treating BPH, one that doesn’t require cutting or removing prostate tissue.
PAE works with your body’s natural processes. Instead of removing tissue, we precisely target the blood vessels that feed your prostate. Using advanced imaging guidance, our experienced interventional radiologists access these vessels through a tiny pin-sized hole in your wrist or groin. We then introduce microscopic particles that reduce blood flow to the prostate, causing it to shrink naturally over time.
What makes PAE truly special is its combination of effectiveness and gentleness. The procedure is performed under local anesthesia, meaning you’re awake but comfortable throughout. There is no cutting, no tissue removal, and no need for a hospital stay. All of our patients return home on the same day and resume their normal activities within days.
Each of these procedures has its benefits and considerations. While we can’t directly compare PAE to these treatments due to limited head-to-head studies, we do have strong clinical evidence comparing PAE to the traditional TURP procedure, showing comparable symptom improvement with fewer risks of sexual side effects.
The Benefits and Results of PAE
When considering PAE, you’ll want to know what results you can expect. Here’s what clinical studies and our experience show:
- About 85-90% of properly selected patients see significant improvement in their symptoms
- Most men begin noticing improvements within 2-4 weeks after the procedure
- Maximum benefit is typically achieved within 3-6 months
- The improvement can last for many years, with studies showing sustained results at 5+ years
- All patients go home on the same day of the procedure
- About 20% of men report improved sexual function following PAE.
It’s important to understand that results can vary. Some factors that influence success include:
- The size and structure of your prostate
- Your overall health and age
- The severity of your symptoms
- Your prostate’s arterial anatomy.
Why don’t all patients improve? Several factors can affect outcomes:
- Very large prostates (over 100 grams) may have less predictable results
- Complex arterial anatomy can make the procedure technically challenging
- The presence of certain bladder conditions might limit the improvement
- Some men may have other underlying conditions contributing to their symptoms.
This is why we conduct thorough evaluations before recommending PAE, ensuring you’re a good candidate for the procedure.
What to Expect: Before, During, and After PAE
Understanding the complete process helps you make an informed decision and sets realistic expectations.
Before the Procedure
First, you’ll have a consultation where we:
- Review your symptoms and medical history
- Perform necessary imaging to examine your prostate and arterial anatomy
- Discuss your specific situation and expected outcomes
- Answer all your questions about the procedure
- Provide clear instructions for preparation.
During the Procedure
The PAE procedure itself is straightforward:
- You’ll receive local anesthesia and light sedation if needed
- The procedure takes about two hours
- You’ll lie comfortably on your back
- You can communicate with your doctor throughout
- Most patients experience minimal discomfort.
After the Procedure and Recovery
Here’s what you can expect after PAE:
- You can return home within a few hours
- Most men return to normal activities within 2-3 days
- Some men experience mild pelvic discomfort for a few days
- You might notice slightly darker urine for 24-48 hours
- Improvement in symptoms typically begins within 2-4 weeks
- Full benefits usually develop over 3-6 months.
Long-term Expectations
We believe in setting realistic expectations for long-term outcomes:
- Most men maintain improvement for several years
- Some men may need additional treatment after 5-7 years
- Regular follow-up helps monitor your progress
- Future treatment options remain available if needed.
Supporting Your Recovery
We stay with you throughout your recovery journey:
- Regular check-ins to monitor your progress
- Clear communication channels for any concerns
- Guidance on resuming activities
- Long-term support for your prostate health.
Our Commitment to Excellence and Transparency
You deserve excellent care and straightforward, honest information about expected outcomes. Unlike many medical practices, we actively track all of our patient outcomes. We maintain a comprehensive database of all our PAE procedures, monitoring:
- Symptom improvement using standardized scoring systems
- Quality of life changes
- Patient satisfaction
- Complication rates
- Long-term durability of results.
Our results consistently meet or exceed published clinical benchmarks, and we regularly review this data to continuously improve our care. During your consultation, you can discuss our current outcomes data. This transparency helps you make an informed decision about your care while holding us accountable to the highest standards of medical excellence.
Understanding how other patients have responded to PAE can be helpful, but remember that each person’s situation is unique. During your consultation, we’ll discuss how your specific factors might influence your expected outcome. Book your consultation today to learn if PAE might be the solution for you.
