Prostate Center Paris

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Frequently asked questions

Doctors' false claims

Your doctor tells you it's still in the experimental stage. FALSE, the procedure is over ten years old, with over 400 articles in the literature.

Embolization is officially recommended in England by the Health Authority as the standard treatment for the prostate. This recommendation is currently being validated in the USA.

There isn't enough experience of the risk of embolization?

On the contrary, the risks are well known, and are becoming increasingly rare thanks to improvements in technique and the miniaturization of the equipment used.

What is prostatic hyperplasia?

Benign prostatic hyperplasia (BPH) is a natural evolution of the prostate gland, which will increase in size. This increase in volume blocks the duct through which urine passes before leaving the body.

What is prostatic artery embolization?

Prostatic artery embolization is a non-surgical method of treating a large prostate by blocking the arteries supplying the gland, thereby shrinking it. It is performed by an interventional radiologist, rather than a surgeon, and is an alternative to TURP (trans urethral resection of the prostate) surgery.

It's a simple method with few risks, including virtually no sexual dysfunction complications.

Why should I need a prostatic artery embolization?

Other tests you've had done have shown that you have an enlarged prostate, and that it's causing you considerable symptoms.
How can I prepare for prostatic artery embolization?

Admission to a day hospital for an outpatient procedure and return home the same day.

You need to be young four hours in advance (solids and liquids). You may be given a sedative to relieve anxiety. You will be asked to put on a hospital gown. As the procedure is generally performed using the large artery in the groin, you may be asked to shave the skin around this area.

If you have any allergies, please inform your doctor. If you have ever reacted to the injection of intravenous contrast material (the dye used in CT scans), you should also inform your doctor.

Where will the procedure take place?

Usually in a vascular room with X-rays, which is suitable for specialized interventional radiology procedures.

What happens after the operation?

You will be taken back to the recovery room. The nurses will perform routine observations, such as taking your pulse and blood pressure, to ensure there are no adverse effects. They will also examine the skin entry point to make sure there is no bleeding from it. Once the pain has been controlled, you will be transferred to your room. You will remain in bed for 2 hours.

You will usually be allowed to go home after four to six hours. Once you're home, you should rest for three or four days. You will be prescribed painkillers if necessary.

If you have any allergies, please inform your doctor. If you have ever reacted to the injection of intravenous contrast material (the dye used in CT scans), you should also inform your doctor.

The procedure is not reimbursed in France?

The procedure is fully reimbursed by social security and mutual insurance companies.

What's the diagnosis?

Symptoms of BPH include problems with urination, such as low urine output, urgency to urinate, inability to empty the bladder and, finally, the need to get up frequently at night to urinate, bladder leakage.

What treatment?

Moderate symptoms can be treated with medication to relax the smooth muscles of the prostate and bladder neck.

When medical treatment is insufficient, patients can be treated surgically. Current surgical treatments include transurethral resection of the prostate, laser surgery, transurethral electrovaporation and open prostatectomy. Surgery almost invariably results in retrograde ejaculation, and carries a risk of complications including bleeding, infection, strictures, incontinence and sexual dysfunction.

Prostatic artery embolization involves injecting small particles into the blood vessels supplying the prostate. This blocks the blood supply, with the aim of shrinking the prostate.

Who will perform the prostatic artery embolization?

A specially trained physician called an interventional radiologist. Interventional radiologists have particular expertise in the use of X-ray equipment, as well as in the interpretation of the images produced. They must look at these images while performing the procedure.

Consequently, interventional radiologists are the people best trained to insert fine needles and catheters into blood vessels, through the skin, and place them correctly.

What happens during prostatic artery embolization?

How long does the procedure take?

Every patient's situation is different, and it's not always easy to predict the complexity or simplicity of the procedure. Some prostatic artery embolisations don't take very long, perhaps an hour. Other embolisations can take up to two hours.

Is the procedure painful?

When the local anesthetic is injected, it may sting a little. Afterwards, you won't feel a thing.

Are there any complications?

Prostatic artery embolization is a new procedure. Based on published data, it appears to be safe, but there is always a risk of complications arising, as with any medical treatment.

Sometimes there may be a small bruise, called a hematoma, around the site where the needle was inserted, and this is perfectly normal. If it becomes a large bruise.

Minor complications such as blood in the urine or semen may occur transiently after embolization. 
The patient may complain of lower abdominal pain for a few weeks.
Serious but very rare complications have been reported in the literature:

 -Bladder hemorrhage with necrosis.

- Rectal necrosis. 

- Impotence (exceptional).

 –Penile necrosis.

Most patients experience some pain afterwards; it's usually mild. Very occasionally a urinary catheter may need to be placed.


What are the results of prostatic embolization?

Study results are excellent. Over 70% of men will achieve symptomatic improvement after PAE, with a reduction in prostate volumes and an increase in urinary flow rates. The impossibility of entering the prostatic arteries can lead to technical failure in around 10% of cases. In the event of failure, traditional TURP surgery may be proposed.

If you have any allergies, please inform your doctor. If you have ever reacted to the injection of intravenous contrast material (the dye used in CT scans), you should also inform your doctor.