Half of all men in their 60s suffer from enlarged prostates that cause discomfort and inconvenience, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). By the time men are in their 70s and 80s, up to 90 percent will have benign prostatic hyperplasia (BPH), the most common noncancerous prostate problem. Studies show prostate artery embolization (PAE), a new catheter-based procedure, is bringing men long-term symptom relief.
Get to Know Your Prostate
The prostate is a walnut-sized gland between your bladder and pelvic floor. Its main function is to produce fluid that protects and enriches sperm. When you turn 25, your prostate begins to grow gradually. Eventually, it may press on your urethra, the tube that carries urine out of your body. Like a foot stepping on a garden hose or fingers pinching a drinking straw, it constricts your urethra, impeding urine flow. This forces your bladder to work harder to expel stored urine.
Straining to urinate just aggravates your condition. As with any muscle, exertion thickens your bladder wall, leaving less room to hold urine. This causes your bladder to contract involuntarily, which causes frequent and urgent urination. Eventually, your bladder becomes so thick that it loses its elasticity and no longer can empty itself.
According to Harvard Medical School, 50 to 60 percent of men with enlarged prostates may never notice troublesome signs. Others find BPH makes life miserable. Lower urinary tract symptoms can include:
Hesitant, slow, interrupted or weak urinary stream
Difficulty starting and stopping urine flow
Urgency with leaking or dribbling
Frequent urination, especially overnight
Persistent need to urinate
Sense of incomplete emptying
Discomfort when urinating
Blood in urine or semen
Reduced ability to get an erection
Consider Traditional Treatments
Doctors have been treating BPH with prescription medications and surgery for years. Your urologist may prescribe a 5-alpha-reductase inhibitormedicine like Dutasteride to increase urine flow and lower your need for prostate surgery.
Transurethral resection of the prostate (TURP) removes the enlarged prostate piece by piece. In the U.S., approximately 150,000 enlarged prostate patients have TURP surgeries annually. Experts note it can cause complications such as sexual dysfunction, impotence and urinary incontinence. Luckily, a new treatment solution is on the horizon.
Discover the Prostate Artery Embolization Alternative
PAE is a minimally invasive outpatient procedure without the need for hospital admission and general anesthesia. While the procedure is new, interventional radiologists use similar techniques and equipment regularly to treat uterine fibroids. Because PAE doesn’t involve open surgery, it’s less painful than TURP. Before this technique begins, the patient receives a twilight sedative medication or local anesthetic.
Much like cardiac catheterization, an incision isn’t necessary. An interventional radiologist uses x-ray guidance to thread a tiny catheter into an artery in the groin that supplies blood to the prostate. Injecting tiny beads into the artery embolizes or blocks the blood supply to the prostate temporarily. This causes the gland to shrink and soften, taking pressure off the urethra, which relieves symptoms.
Explore PAE Studies
Researchers discharged patients three to six hours after treatment and followed up with them at three intervals. The study team reported improvement in 87.2 percent of men after three months, 80.2 percent after 18 months and 72.3 percent after three years. The results were similar to surgery but without causing sexual dysfunction or impotence. In addition, 31.6 percent of the men reported improved sexual performance.
After a Brazilian study treated 120 enlarged prostate patients with prostate artery embolization, 97 percent of the men experienced symptom and quality of life improvements. Researchers followed patients for an average of 15 months. None experienced adverse side effects. The study team reported its four-year study suggests that PAE is safe and effective with a low rate of complications.
At Inova Alexandria Hospital in Virginia, researchers performed PAE on men with an average age of 67. Study lead author and interventional radiologist Dr. Sandeep Bagla reported 94 percent of subjects had significant decreases in their symptoms one month after PAE. None of the participants required hospital admittance after the procedure or reported any major complications such as impotence, urine leakage, infection or post-procedural pain.
Bagla said PAE is a less expensive alternative to most current surgical procedures because it doesn’t require an operating room and overnight hospital stay. He expects this treatment will become more widely available by the end of the year.
Prepare for Relief
Work closely with your urologist to be sure enlarged prostate is the cause of your symptoms. Some of the first U.S. health care providers to perform PAE include Inova Alexandria Hospital and Inova Mount Vernon Hospital in Alexandria, Virginia, the University of North CarolinaCenter for Heart and Vascular Care in Chapel Hill, North Carolina, and RIA Endovascular in Greenwood Village, Colorado. If your doctor says prostate artery embolization is an appropriate therapy for you, be on the lookout for clinical trials and facilities in your area offering this treatment. Soon, you can quit wasting valuable time in the bathroom and free up more quality time to enjoy life.