Benign prostatic hyperplasia or BPH is so common that it’s been said that all men will have an enlarged prostate if they live long enough. The minimally invasive interventional radiology treatment-prostatic artery embolization or PAE-will be the future treatment for benign prostatic hyperplasia or men’s noncancerous enlarged prostates. Prostatic artery embolization blocks blood supply to treat noncancerous benign prostatic hyperplasia. While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical results-without TURP’s limitations and risks.
TURP can be performed only on prostates smaller than 60 cubic centimeters (cc); there is no size limitation for PAE treatment. The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms. Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anesthesia.
BPH is not cancer; it is a condition that affects a man’s prostate, a gland found between the bladder and the urethra. As a man ages, the prostate gland slowly grows bigger (or enlarges) and may press on the urethra and cause the flow of urine to be slower and less forceful. BPH is characterized by urinary frequency, urgency, passing urine more often (particularly at night), weakened stream and incomplete bladder emptying. Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment.
Prostatic artery embolization is performed by an interventional radiologist, a physician who is trained to perform this and other types of embolization and minimally invasive procedures. An interventional radiologist makes a tiny nick in the skin in the groin and inserts a microcatheter into the femoral artery. Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, the size of grains of sand, into the prostatic arteries that supply blood to the tumor. These tiny particles block blood flow to the tumor, causing it to shrink. Following PAE treatment, most men experience no pain to light pain and leave the hospital four to eight hours after intervention. There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure.
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