Benign prostatic hyperplasia is not dangerous, but it is relentless. The prostate enlarges, squeezes the urethra running through it, and the bladder spends years fighting to push urine past the obstruction. The result is the familiar list: a weak stream, hesitancy, straining, a stream that stops and starts, the sense that the bladder never quite empties, and the nightly trips to the bathroom that quietly wreck sleep.
Conventional surgical treatments work by removing or destroying prostate tissue from inside the urethra. They are effective, but they involve instrumenting the urethra, they usually require a catheter afterward, and they carry a meaningful rate of retrograde ejaculation and other sexual side effects.
Prostate artery embolization takes an entirely different route. We reach the prostate through its arteries and reduce its blood supply. Deprived of that supply, the gland shrinks over the following weeks and the pressure on the urethra falls. The urethra is never instrumented. In our practice, patients go home the same day without a urinary catheter.
The team here is unusual in this respect: Dr. Golowa was a co-investigator in the early United States clinical trials of PAE and performed his first case in São Paulo in 2013 under one of the physicians who pioneered the technique. Between our centers we have performed well over a thousand of these procedures.
What the procedure involves
Evaluation by a urologist and an interventional radiologist
Both specialties see you. That matters — the decision about whether PAE is the right choice, or whether a different BPH treatment fits you better, should be made by people who can offer all of them.
Access through a pinhole
A needle enters the artery at the wrist or groin. A microcatheter is guided to the arteries supplying the prostate under live imaging.
Embolization of both sides
Microscopic particles are released into the prostatic arteries, reducing the gland's blood supply. Both sides are treated in the same sitting.
Home the same day, no catheter
The microcatheter is removed. There is no incision to close and nothing left behind. Symptoms improve gradually over the following weeks as the prostate shrinks.