Prostate Artery Embolization BPH Treatment in Men: Office Procedure in New York and New Jersey
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients.
We offer affordable prices with or without insurance. Same-day virtual video appointments and in-person appointments are available.
What is Prostate Artery Embolization?
Prostate artery embolization is a procedure designed to block the arteries that supply blood to the prostate. By cutting off blood supply to the prostate, the prostate tissue dies off (or undergoes necrosis and resorption). The end result is that the prostate shrinks in size. Prostate artery embolization can be performed for the treatment of prostate bleeding but more commonly performed for the treatment of BPH symptoms in men with an enlarged prostate.
How Effective is Prostate Artery Embolization for Treatment of BPH in Men?
It appears that prostate artery embolization has good efficacy in published studies for the treatment of men with an enlarged prostate. However, it is important to understand that studies that have been published have numerous limitations, including the fact that many have a high dropout rate after treatment. A high dropout rate means that patients do not follow-up after the procedure; as a result, it is impossible to verify whether these patients have improved or had severe complications. Often, men who do not see clinical improvement and those who experience severe complications do not follow up with the same physician and seek a second opinion elsewhere.
Where to Get Enlarged Prostate Treatment in NYC?
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: 1-646-663-4044 or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
What are the Different Ways to Embolize the Prostate Gland?
The prostate gland gets blood supply from the right and left branches of internal iliac arteries. Prostate embolization can be achieved by embolizing both prostatic arteries on right and left side or by embolizing only one side. Typically, studies show that the embolization of both prostatic arteries results in higher clinical success rates of prostate artery embolization.
The PERFecTED technique for PAE: Two-step embolization technique where after initial administration of microspheres (beads) that are 100-500 micron (1/1000 of a meter) made of hydrogel or polyvinyl alcohol (PVA), the catheter is pushed deeper in, and additional microbeads are administered.
Traditional embolization technique: is a one-step prostate artery embolization technique where the catheter is not advanced further into the prostatic artery for the second dose of microsphere administration. It appears that the traditional technique is less effective than the PERFecTED technique. For technical reasons, sometimes only traditional techniques can be accomplished.
Use of different embolization materials: embolization can be achieved using coils (not commonly used for prostate artery embolization). Microbeads are the most commonly used material for prostate artery embolization, typically using a 2.7F (very tiny and narrow) catheter.
How does Prostate Artery Embolization Compare to Urolift?
No study has directly compared prostate artery embolization to the Urolift procedure. Based on the indirect comparison, the Urolift procedure is associated with fewer risks and complications than prostate artery enucleation.
How Does Prostate Artery Embolization Compare to Bipolar TURP?
In the study comparing TURP and prostate artery embolization, the TURP procedure resulted in somewhat better urine flow than the PERFecTED technique for PAE. The original embolization technique is less effective than the PERFecTED technique for PAE. (Carnevale et al 2016) . Patients after TURP had more short-term complications but the clinical success of TURP surgery was somewhat better than of prostate enucleation with 4% in the TURP group and 9% in the PAE group not improving after treatment. Clinically TURP and prostate artery embolization, and particularly when performed using bilateral PERFectTED technique results in similar improvement in symptoms as measured by the AUA symptom score.
Risks and Side Effects of Prostate Artery Embolization.
The prostate is a part of the urinary tract and is often a harbinger of infection. After prostate artery embolization, necrosis of prostatic tissue, which is the desired effect of prostatic artery embolization, predisposes to increased risk of infection within the prostate and formation of a prostatic abscess. Because of the risk of infection, antibiotic prophylaxis is often prescribed after the procedure.
- Dysuria: 9%-15%
- Urinary infection: 7%
- Blood in urine: 5%
- Blood in semen: 0.5% (but likely higher as many patients may not ejaculate after the procedure for a while)
- Urinary retention: 10-20%
- Rectal bleeding: 3%
Embolization of Prostate Tissue Can Cause Flu-like Symptoms.
Prostate artery embolization is associated with small risks of hematomas, pseudoaneurysms, and nonselective embolization of adjacent organs as well as other organs.
Men may experience pain, urethral burning, and urinary frequency after prosthetic artery embolization, possibly related to non-targeted embolization.
Patients may experience pelvic pain and discomfort, perineal, suprapubic, rectal, urethral, and testicular pain. Men can also experience frequent urination, a sensation of incomplete bladder emptying, and ejaculatory pain. Some men experience nausea and vomiting, as well as febrile symptoms due to post embolic inflammatory syndrome (PES). This occurs in about 10% of patients.
Superior rectal artery connects to the branches of the prostatic artery in as many as 30% of patients. This can cause ischemic damage to the rectum, rectal pain, blood per rectum, and other rectal side effects such as erosions, fistula, or abscess.
Radiation Exposure During Prostate Artery Embolization
Fluoroscopy, a type of radiation to visualize the arterial supply to the prostate, is used during prostate artery embolization. Studies report procedure time from 1 hour to 2 hours and the radiation exposure rate as measured by fluoroscopy time anywhere from 30 minutes to 1 hour. This is a large amount of radiation. Long-term repercussions are not known, but at higher doses, radiation to the pelvis can increase the risk of bladder cancer and rectal cancer.
How Successful is PAE for BPH Treatment?
It is important to understand the difference between technically successful prostate artery embolization, which simply means that embolization was performed as planned, and clinically successful embolization. Clinically successful embolization means that embolization actually helped the patient with his symptoms. A technically successful embolization may not be clinically successful if patient symptoms are not improved after PAE.
Technically successful prostate artery embolization can be performed in around 90% of patients with bilateral embolization. Unilateral embolization appears to result in the lower clinical efficacy of prostatic artery embolization.
Based on published studies, it appears that the benefit of prostatic artery embolization is durable for more than a year. Few long-term studies have been published with patients who underwent prosthetic artery embolization.
Clinically studies suggest that 75-80% of patients benefit from prostate artery embolization, with the benefit persisting to 3-6 years. With unilateral embolization, success is lower, around 50% in terms of symptomatic benefit.
Studies Demonstrate That Prostate Artery Embolization Is An Effective Treatment Option For Men With Enlarged Prostate.
PAE shows good efficacy in reducing the urinary frequency in men with IPPS scores going from 24 to 8 (-16) in a large study of patients who underwent PAE. Similarly, the urinary stream can be expected to improve significantly, with peak urinary flow (Qmax) improving from 8.5 to 17 (+9) ml/second.
Bladder Ischemia after Prostate Artery Embolization
Bladder wall ischemia after prostate artery embolization is a reported complication of PAE. Management of bladder wall ischemia is complicated and individualized but may require surgical treatment or conservative management under close monitoring in select patients.
It appears that there is no significant detrimental effect of prostate artery embolization on sexual function. However, studies have not been performed with the specific intent of evaluating the sexual and ejaculatory function.
Who are Not Good Candidates for PAE?
Patients with severe atherosclerosis or vascular disease have a higher risk of failure of PAE.
Some extremely rare complications have been described, such as septicemia and thrombophlebitis of the pelvic veins, sometimes associated with a pulmonary embolism that can even result in death.
How Soon can Prostate Artery Embolization Be Performed?
PAE for BPH is not currently FDA approved for the treatment of a man with BPH and the United States. Most insurances do not cover the cost of prostate artery embolization for the treatment of enlarged prostate. PAE is available through some institutions as part of the studies. Commercially available PAE requires out-of-pocket payment for the procedure.
What Are My Options Right Now For Treatment Of Enlarged Prostate?
For patients suffering from symptoms of the enlarged prostate such as slow urine stream, urinary urge, frequent urination, and waking up at night to urinate, procedures such as Urolift procedure and Rezum procedure are currently available in the United States and have similar efficacy and safety profile as iTind. These procedures are performed in our offices at New York Urology Specialists.
For men with very large prostates, laser enucleation of the prostate using MOSES Holmium laser (MoLEP) is a good and effective treatment option. Aquablation provides effective treatment, similar to HOLEP. Our surgeons are experienced in performing laser enucleation of the prostate.
Did you know? Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
Cost of Enlarged Prostate Treatment without Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
At New York Urology Specialists, we offer a flat-fee ‘all-cost-included’ Rezum procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment. Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.
At New York Urology Specialists, we offer a flat-fee ‘all-cost-included’ Urolift procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.
Cost of Treatment and Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
We accept many health insurance plans. We would be happy to verify your eligibility and benefits and provide you with detailed information on your health plan’s coverage. Financing options and credit options are available to help you pay for medical care.
Read Real Stories of Men who Underwent Treatment of Enlarged Prostate (BPH) at New York Urology Specialists
We offer treatment for prostate problems, including slow urine stream, frequent urination at night, difficulty emptying the bladder, and other problems to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, Connecticut, and over 70 countries worldwide.
- 46-year-old Man with Urinary Retention Treated with Urolift
- 47-year-old Man Treated with Rezum Procedure After Unsuccessful Urolift
- 63-year-old Man with Urinary Problems after Prostate Cancer Radiation Treated With Urolift
- 75-year-old Man Treated with Urolift Procedure after Rezum did not work
Why Choose New York Urology Specialists for Treatment of Enlarged Prostate Problems?
- All treatment is performed by a board-certified urologist experienced in treating men with symptoms of frequent urination, urinary urgency, urinary incontinence, and bladder pain using medical therapy, minimally invasive therapies, lasers, and open surgery.
- We are one of the few practices in the region to offer a full range of options for the treatment of urinary problems caused by an enlarged prostate in men.
- We offer treatment options for enlarged prostate, overactive bladder, UTI, and urinary incontinence in our office, which avoids the risks, costs, and recovery from general anesthesia.
- Extensive experience: Thousands of men have been treated successfully using medical therapy, surgery, and minimally invasive procedures such as Urolift procedure, Rezum surgery, Botox for overactive bladder, Interstim for frequent urination, and tibial neuromodulation.
- We also offer laser surgery for BPH (Holmium, Thulium, Evolve, Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
- We offer diagnostic testing in our office, which avoids hospital costs.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
- We are conveniently located within a 30-60 minute commute to men who are seeking BPH treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.
What do Prostate Problems Look Like?
You can find images of uroflow as well as before and after treatment images in our image gallery.
Scheduling Appointments for Enlarged Prostate Treatment at New York Urology Specialists
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance. We offer weekday, weekend, and evening office hours.
Urinary Problems Are Treatable in Nearly Every Man and Woman
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of urinary problems caused by enlarged prostate and BPH in men. We understand the challenges that urinary problems such as a slow stream, waking up at night, pain in the penis and perineum create for our patients, their relationships, and their self-esteem. We help you find a treatment for your urinary problems that fit your needs, lifestyle, and your preferences.
Urologists are doctors specializing in the treatment of men with symptoms caused by prostate enlargement, including frequent urination, poor urine flow, frequent UTI, blood in urine, urinary incontinence, urinary problems caused by an enlarged prostate, prior surgery, neuropathy, chemotherapy, and radiation. By virtue of our experience and skill, we can offer an effective treatment option for nearly every man and woman who desire an effective treatment for their urinary problems. We offer medical and surgical treatment for men’s prostate problems.
We specialize in minimally invasive, highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency.
We Treat Some of the Most Complex Men’s Health Problems Including:
- Erectile dysfunction in men for whom oral pills do not work.
- Penile Pain During Sex
- Impotence in men with diabetes.
- Burning during urination
- Premature Ejaculation
- Frequent urination
- Urinary retention
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Schedule an Appointment with Dr. Shteynshlyuger:If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance.
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