UW Radiology

Men’s Health Interventions

1. Prostate artery embolization

Enlargement of the prostate (benign prostatic hyperplasia, BPH) is a common condition in older men that can cause urine leakage, irritation with urination, increased urinary frequency, and pain with urination. BPH occurs in one out of four men over the age of 55 and in half of men over the age of 75. When symptoms related to BPH become bothersome, there are several treatment options including surgery. However, prostate artery embolization is a non-surgical, minimally invasive alternative. The procedure is performed by guiding a catheter into the prostatic artery from an artery in the wrist or groin using real time x-ray imaging (fluoroscopy). Once the catheter is properly positioned, microscopic spheres are delivered through the catheter and become lodged in the prostatic artery, cutting off the blood supply and causing the prostate to shrink. This typically results in symptom relief over the next few weeks. It is important to talk to the Interventional Radiologist about the risks and benefits of this procedure compared to other more invasive surgical procedures. Prostate artery embolization is shown to have lower risk of urinary incontinence and sexual side effects (erectile dysfunction and retrograde ejaculation) when compared to operations such as transurethral resection of the prostate (TURP).

Sedation: Local anesthesia (lidocaine) and moderate sedation (fentanyl and midazolam).

Procedure time: 60-180 minutes.

2. Varicocele embolization

Varicocele is a dilated network of veins within the scrotum that can cause pain, testicular shrinkage, and infertility. The dilated network of veins results from abnormal blood flow in the veins of the pelvis and abdomen, usually on the left side of the body. The varicocele may be treated through varicocele embolization which is a non-surgical and minimally invasive procedure that involves guiding a small catheter into the gonadal veins from a small puncture in the groin after application of a local anesthetic and sedation (fentanyl and midazolam). Once the catheter is positioned in the gonadal vein, embolization coils and sclerosing agents are infused to block the flow of blood from entering the dysfunctional and dilated veins in the scrotum. This results in symptom relief and improved fertility in most patients. Following the procedure, patients return home the same day after a short stay in recovery.

Sedation: Local anesthesia (lidocaine) and moderate sedation (fentanyl and midazolam).

Procedure time: 60-120 minutes.