Overview

This information is about having a prostate embolisation procedure. It is a minimally invasive procedure to treat a condition called benign prostate enlargement (also called benign prostatic hyperplasia).

Benign prostate enlargement is when the small prostate gland near a man's bladder becomes bigger than usual. This is a common condition in men over the age of 50. The condition is non-cancerous (benign) and not usually serious.

A prostate embolisation procedure reduces the size of an enlarged prostate by blocking the blood vessels (arteries) that supply blood to it. This can improve the symptoms of the condition.

The aim of this information is to help answer some of your questions about having a prostate embolisation. It explains:

• the benefits of the procedure 
• the risks of the procedure 
• how to prepare for the procedure 
• what happens during the procedure 
• what happens after the procedure 

If you have any more questions or concerns, please speak to a doctor or nurse caring for you in the interventional radiology (IR) department.

About benign prostate enlargement

The prostate is a small gland, located in the pelvis, between the penis and the bladder.

Benign prostate enlargement, also called benign prostatic hyperplasia, is an enlarged prostate gland.

Benign prostate enlargement is a common condition in men aged over 50. By the age of 70, about 8 in 10 (80%) men have an enlarged prostate.

As the prostate gets bigger, the layer of tissue around it stops the prostate gland expanding. This causes the gland to press against the urethra (the tube through which urine flows).

Symptoms of benign prostate enlargement

An enlarged prostate often does not cause any problems. If you do have symptoms, they might include:

• a weak urine flow
• difficulty in starting to pee
• a feeling that your bladder is not empty after you have peed
• a frequent need to pee

Your doctor has recommended treatment because your prostate is causing problems.

About a prostate embolisation procedure

Usually, prostate embolisation is a day case procedure and you do not need to stay in hospital overnight.

Before your procedure, we give you information about having surgery, how to travel to the hospital and what to bring with you.

Prostate embolisation is a procedure to block the arteries that supply blood to the prostate. It is done under a local anaesthetic. This means that you are awake for the procedure but do not feel pain.

Interventional radiologists (IR doctors) do minimally invasive, image-guided procedures on different parts of the body.

During the procedure, an IR doctor uses an X-ray camera to guide a thin, flexible tube (catheter) to your prostate arteries. They inject small particles to block the arteries and a contrast agent (substance that shows clearly on scans) through the catheter.

Benefits of the procedure

We do a prostate embolisation procedure for benign prostate enlargement when other treatments are unsuitable or high risk. Most people who have the procedure show:

• a reduction in the size of their prostate
• an improvement in their symptoms 
   

Risks of the procedure

Prostate embolisation is thought to be a safe procedure. However, as with any procedure, there are some risks involved.

The most common risks are listed in this section.

Damage to a blood vessel, bruising or bleeding

Any procedure that involves placing a catheter inside a blood vessel (artery) has some risks. They include:

• damage to the blood vessel
• bruising or bleeding where we put in the catheter

When an experienced IR doctor does the procedure, these risks are very small.

Infection

There is a small risk of infection, but we can usually treat this with antibiotics.

Injury to surrounding parts of the body

Very rarely, the small particles used during the procedure may become fixed in the wrong place. This may prevent normal tissue from getting its oxygen supply.

To avoid this complication, the IR doctor carefully examines the pattern of the blood vessels in the pelvis. However, there is still a very small risk of injury to the bladder, rectum (lowest end of the bowels) and genitals. This is because they are close to the prostate.

Allergic reaction

It is possible to have an allergic reaction to the contrast agent used during the procedure. This is a substance used to make structures in the body show clearly on scans.

Allergic reactions range from mild itching to severe reactions that can affect breathing or blood pressure. We monitor you carefully during the procedure. This means that we can notice and treat any allergic reaction immediately.

Procedure not working

There is a chance of about 1 in 10 (10%) that the procedure may not work. This may happen if:

• we cannot block the prostate arteries completely
• you do not respond to the treatment

Post-embolisation syndrome

Post-embolisation syndrome is when you have a more frequent and urgent need to pee after the procedure. If you get this condition, we will give you anti-inflammatory medicines, antibiotics and painkillers. The symptoms usually improve by day 9.

Radiation risks

During the procedure, you are exposed to X-rays. They are a type of radiation called ionising radiation. This may cause cancer many years or decades after you are exposed to it.

You might have some skin redness after the procedure that feels like sunburn. We do not expect this to be permanent. The redness might be harder to notice on brown and black skin.

Interventional radiology (IR) is when we use medical imaging guidance to do minimally invasive procedures. The amount (dose) of radiation from these procedures is generally low. More complex procedures might involve a medium (moderate) dose of radiation.

The IR doctor and radiographer (health professional who specialises in medical imaging) make sure that:

• your radiation dose is kept as low as possible
• the benefits of having X-rays during your procedure are greater than the radiation risks

Other treatment options

You do not always need treatment for benign prostate enlargement.

If your symptoms are troublesome and you need treatment, there are several options. Your specialist doctor (urologist) talks to you about any treatment options that may be suitable, including medicines and surgery.