Prostate Artery Embolization Discharge Instructions
Pain and Discomfort
Most men have pain and discomfort in the pelvis after PAE; it typically lasts one to two weeks, improving as the days go on. Men describe it as a burning sensation in the bladder similar to a urinary tract infection. It is usually worse when urinating. And men often say they have burning at the tip of the penis when they urinate.
Also, most men report a sense of urgency to begin urinating as soon as they get the urge to go.
The medications I prescribed for you will help relieve this pain and discomfort. The Medrol dose pack and the ibuprofen will significantly reduce the pain by reducing inflammation. Make sure you take these medicines with food to reduce the chance of stomach problems.
I used to prescribe a narcotic but have found that almost no one needed it so I have stopped doing that.
Also, most men report a sense of urgency to begin urinating as soon as they get the urge to go.
The medications I prescribed for you will help relieve this pain and discomfort. The Medrol dose pack and the ibuprofen will significantly reduce the pain by reducing inflammation. Make sure you take these medicines with food to reduce the chance of stomach problems.
I used to prescribe a narcotic but have found that almost no one needed it so I have stopped doing that.
Puncture Sites
The arterial puncture site at the top of your right and/or left leg has a Band-Aid covering it. You may shower but replace the wet Band-Aid with a clean dry one today and the following two days. This action will promote healing at the site. You may remove the Band-Aid on the fourth day. Normally, some bruising at the puncture site is observed. The bruise tends to spread out and change colors from red-purple to yellow-blue-green over several days. This process is the normal way that a small amount of blood under the skin is reabsorbed and should not alarm you.
Rarely, in less than 1 in 500 patients, there can be significant bleeding at the groin(s). If you notice sudden swelling or active bleeding from the puncture site, you should use direct pressure by placing your fingers and a clean cloth or paper towel over the site. Call for assistance and report to the nearest emergency room for evaluation.
For most patients we deploy a plug, called a Mynx or a Vascade, under the skin and above the artery, that helps prevent bleeding. This plug absorbs over a few days to a week and can cause some discomfort at the site. So if you ache a bit at the site that is most likely the plug absorbing or a small bruise.
Rarely, in less than 1 in 500 patients, there can be significant bleeding at the groin(s). If you notice sudden swelling or active bleeding from the puncture site, you should use direct pressure by placing your fingers and a clean cloth or paper towel over the site. Call for assistance and report to the nearest emergency room for evaluation.
For most patients we deploy a plug, called a Mynx or a Vascade, under the skin and above the artery, that helps prevent bleeding. This plug absorbs over a few days to a week and can cause some discomfort at the site. So if you ache a bit at the site that is most likely the plug absorbing or a small bruise.
Diet, Medications, Activity
Resume your normal diet and medications, including Flomax or any other medication you were taking for BPH. You should slowly increase your activity over the next three to four days.
Don’t do an exercise that puts lots of strain on the puncture site at your groin for the first 10 days.
Do not ride a bike, any kind of bike, including exercise bike, for 21 days after your PAE as this can cause severe prostate inflammation. Otherwise you may have unrestricted activity, including sexual activity and exercise, 10 days after the procedure.
As stated above, expect to have bladder/prostate irritation over the next several days to two weeks. You may also find you have an urgent need to urinate. The anti-inflammatory medications, Ibuprofen and the steroid pack, will help diminish these sensations.
Don’t do an exercise that puts lots of strain on the puncture site at your groin for the first 10 days.
Do not ride a bike, any kind of bike, including exercise bike, for 21 days after your PAE as this can cause severe prostate inflammation. Otherwise you may have unrestricted activity, including sexual activity and exercise, 10 days after the procedure.
As stated above, expect to have bladder/prostate irritation over the next several days to two weeks. You may also find you have an urgent need to urinate. The anti-inflammatory medications, Ibuprofen and the steroid pack, will help diminish these sensations.
Heartburn, Constipation
While taking ibuprofen it is important to protect your stomach from irritation. Try to eat some food with each dose.
If you wind up needing a narcotic for pain relief (most men do not) a common side effect of any narcotic is constipation and excess gas. You need to protect yourself against constipation if you take a narcotic. Take Colace; a gentle laxative that you can purchase over the counter at your pharmacy (I recommend 300 mg daily if using Norco). Feel free to also use Milk of Magnesia or a glass of prune juice prior to drinking your morning coffee. Phazyme is another over the counter medicine that can help relieve gas pain. Also, remember to drink lots of water; try to down 8 glasses of water a day.
If you wind up needing a narcotic for pain relief (most men do not) a common side effect of any narcotic is constipation and excess gas. You need to protect yourself against constipation if you take a narcotic. Take Colace; a gentle laxative that you can purchase over the counter at your pharmacy (I recommend 300 mg daily if using Norco). Feel free to also use Milk of Magnesia or a glass of prune juice prior to drinking your morning coffee. Phazyme is another over the counter medicine that can help relieve gas pain. Also, remember to drink lots of water; try to down 8 glasses of water a day.
Fever
A mildly elevated temperature is a common side effect of PAE, occurring in about one-third of patients.
High temperatures, greater than 102°, are of some concern. Call the clinic as described at the end of this instruction set if your fever reaches 102° or greater. Fever is a side effect of the dying BPH nodules and usually does NOT indicate an infection. Infection is unlikely to occur, especially if you take the antibiotic as instructed, but if it happens it is more likely to develop 10-14 days after the procedure than in the first few days following PAE.
High temperatures, greater than 102°, are of some concern. Call the clinic as described at the end of this instruction set if your fever reaches 102° or greater. Fever is a side effect of the dying BPH nodules and usually does NOT indicate an infection. Infection is unlikely to occur, especially if you take the antibiotic as instructed, but if it happens it is more likely to develop 10-14 days after the procedure than in the first few days following PAE.
Summary of medicines I may prescribe for you
Prescription, take these as directed
Brand name Generic name
Anti-inflammatory Motrin Ibuprofen
Anti-inflammatory Medrol Dose Pack
Antibiotic Cipro Ciprofloxacin
Prescription, take these only if you need them
Pain relief, moderate Lortab or Norco Hydrocodone
Over the counter, take these only if you need them
Laxative Colace Docusate
Anti-gas Phazyme Simethicone
Brand name Generic name
Anti-inflammatory Motrin Ibuprofen
Anti-inflammatory Medrol Dose Pack
Antibiotic Cipro Ciprofloxacin
Prescription, take these only if you need them
Pain relief, moderate Lortab or Norco Hydrocodone
Over the counter, take these only if you need them
Laxative Colace Docusate
Anti-gas Phazyme Simethicone
Blood in urine, stool, semen
It is not unusual to have a small volume of blood in your urine, semen, or stool for the first several days after PAE.
Signs of Potential Problems
Symptoms that might indicate problems include pain that is becoming increasingly severe for days after the initial pain resolved; a temperature of over 101.5 or inability to void.
Another issue that can be seen, rarely, is development of a rash or ulcer on your penis.
If any of these symptoms occur, please contact us so that we can assess the symptoms and make further treatment recommendations.
Another issue that can be seen, rarely, is development of a rash or ulcer on your penis.
If any of these symptoms occur, please contact us so that we can assess the symptoms and make further treatment recommendations.
Erectile function
PAE does not interfere with erectile function. Your ejaculate may increase or decrease in volume after PAE, though this change is usually temporary. And you may see blood in your semen for the first week or two after PAE.
Follow-up Care with Interventional Radiology
We will see you in three months for a post procedure visit. If you do not get a call from us to schedule it, please call (210) 616-7780 to schedule this visit.
If your symptoms do not resolve in the expected time frame, or if your symptoms worsen or other questions develop, we can schedule an earlier return visit. Please tell us if you are having issues, otherwise we have no way of knowing!
We may contact you on occasion to check on your well-being but there is no routine scheduled follow-up beyond the three-month visit.
If your symptoms do not resolve in the expected time frame, or if your symptoms worsen or other questions develop, we can schedule an earlier return visit. Please tell us if you are having issues, otherwise we have no way of knowing!
We may contact you on occasion to check on your well-being but there is no routine scheduled follow-up beyond the three-month visit.
If you have a question or problem…
If at any time you have any questions regarding the procedure or any symptoms you might have, please feel free to call us. Call the STRIC nurse at (210) 617-9444, he or she can usually answer your question and if not knows how to reach your IR doctor.