Prostate Artery Embolisation PAE

NICE (National Institute for Health and Care Excellence) reported in April 2018 on the benefit of prostate artery embolisation for benign prostatic hyperplasia (BPH).
This procedure works well for lower urinary tract symptoms caused by benign prostatic hyperplasia, and there are no serious concerns about its safety.

PATIENT ADVICE:

Prostate artery embolisation for benign prostate hyperplasia:

NICE (National Institute for Health and Care Excellence) reported in April 2018 on the benefit of prostate artery embolisation for benign prostatic hyperplasia (BPH).

This procedure works well for lower urinary tract symptoms caused by benign prostatic hyperplasia, and there are no serious concerns about its safety.

Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate. It can block or narrow the tube that urine passes through to leave the body, causing difficulty in passing urine. Mild to moderate symptoms are managed conservatively with drugs, when these treatments fail currently surgical options such as trans-urethral resection (TURP) or green light laser or prostatectomy are considered. Prostate artery embolisation (PAE) now offers an interventional radiology (image guided surgical) treatment option with reduction in prostate size obtained via a 2-3mm incision.

In this procedure, using X‑ray guidance, a thin tube called a catheter is inserted into an artery in the groin or wrist. It is guided into the blood vessels that supply the prostate. Tiny plastic particles are then injected into these vessels causing shrinkage of the prostate gland.

PAE is a safe procedure, however not everyone is suitable for the procedure. We have provided a list of centres below that were involved in the initial registry of prostate embolisation (UK-ROPE) who can offer advice regarding this procedure. Other centres maybe able to offer the treatment but it is essential that the decision is made in a multidisciplinary team with a urologist, UK-ROPE centres work closely with urologists as part of the study.

It is important that you should discuss PAE with your urologist and Interventional Radiologist (Image Guided Surgeon) to ensure that this procedure is correct for your particular situation. Those performing the PAE procedure will ensure that you complete both the international prostate symptom score (IPSS) and international index of erectile function (IIEF) prior to the procedure. These are essential outcome measures, completed before and after the procedure, to ensure success and future development of PAE. It may be that you will need to have further imaging to assess this e.g. multi-parametric MRI Prostate and CT angiography.

An Interventional Radiologist would be happy to see you in his clinic to discuss matters further and liaise with his urologist, whereas some centres will be able to offer combined clinics or to see a urologist followed by an Interventional Radiologist.

 

 

Centres offering PAE:

Southampton: Dr Bryant / Dr Modi

Newcastle, Freeman Hospital: Dr Phil Haslam and Dr Pete Littler

Birmingham University Hospital Birmingham: Dr Ian McCafferty

Oxford Churchill Hospital: Dr Ross Tapping

Bournemouth General Hospital: Dr Clare Bent

Coventry University Hospitals Coventry: Dr James Harding

Stoke, University Hospital North Midlands, Stoke: Dr David Wells

Frimley Park Hospital: Dr Jeremy Taylor

Canterbury, East Kent Hospitals: Dr Neelan Das

Manchester Royal Infirmary: Dr Anantha-Krishnan Ganapathy

Liverpool, Royal Liverpool University Hospital: Dr Pradesh Kumar

Colchester General Hospital: Dr Arun Sebastian

Plymouth:   Dr Richard Miles

London:

Guys and St Thomas: Dr Tarun  Sabharwal 

St Marys Hospital, Imperial: Dr Nick Burfitt

Northern Ireland:

Belfast City Hospital: Dr Richard Lindsay

Scotland:

Queen Elizabeth Hospital, Glasgow: 

Royal Berkshire NHS Foundation Trust, Reading, Dr M W Little

North Bristol NHS Trust, Southmead Hospital, Dr Peter Mezes

There will be other centres who maybe offering PAE and we recommend you contact your local Interventional Radiology team to check. As matters develop BSIR will update the list of centres offering this service.

 

For further information please see:

  1. Patient information leaflet BSIR 
  2. ROPE BSIR page (https://www.bsir.org/registries/uk-rope-registry-of-prostate-embolisation/#col_right)

 

References:

1. https://www.nice.org.uk/guidance/ipg611

2. The UK ROPE Study: efficacy and safety of prostate artery embolisation for benign prostatic hyperplasia. An observational study and propensity matched comparison with transurethral resection of the prostate. Ray AF, Powell J, Speakman MJ Longford NT, Das Gupta R, Bryant T, Modi S, Dyer J, Harris M, Carolan-Rees G, Hacking, N

BJUI DOI:10.1111/bju.14249