Prostatic artery embolization (BPH)

Background and indications

Benign prostatic hyperplasia (BPH) affects the majority of men over 50 and causes urinary symptoms (frequency, weak stream, nocturia). Embolization is an alternative to surgical treatments (resection, laser) when medications are no longer sufficient.

Benefits

Significant urinary symptom improvement in 80-90% of cases, sexual function preservation (no retrograde ejaculation), outpatient or one-night hospitalization, rapid recovery (3-5 days).

Procedure

Under local anesthesia, a catheter is introduced via the radial (wrist) or femoral (groin) artery. The radiologist navigates to the prostatic arteries on both sides and injects microspheres to reduce blood supply to the prostate. The procedure lasts 1.5-3 hours, depending on vascular anatomy.

Risks

Transient pelvic pain and urinary burning (a few days), puncture site hematoma, urinary infection. Rare complications include bladder or rectal ischemia. No urinary catheter during the procedure is an advantage.

Recovery and follow-up

Same-day or next-day discharge. Follow-up MRI at 3 months with IPSS score evaluation (urinary symptoms). Improvement is gradual over 1-3 months.

Practical information

Local anesthesia. Outpatient procedure (return home the same day).