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What is Benign Prostatic Hyperplasia?
An enlarged prostate gland (also known as benign prostatic hyperplasia or BPH) is extremely common as men age. It is a non-cancerous condition that affects an estimated 14 million men. Symptoms may include the frequent or urgent need to urinate coupled with an increased need to urinate at night. BPH is also linked to erectile dysfunction and reduced libido or sex drive.
What causes BPH?
The prostate gland is located just underneath your bladder. As men age, the walnut-sized gland grows, pushing against the bladder and pinching the urethra. This can cause symptoms that include:
- A weak urine stream
- Difficulty beginning urination or dribbling at the end
- Failure to completely empty the bladder
BPH is very common in older men. It affects half of all men between 51 and 60 years of age and up to 90% of men older than 80. Although benign, the symptoms can be frustrating and lead to poor quality of life because most men with this condition do not wish to live the rest of their lives with its symptoms. Left untreated, BPH can lead to urinary tract infections (UTIs), bladder damage, bladder stones, kidney damage (or chronic renal failure), and urinary retention (the inability to urinate) which may require frequent catheterization.
What are treatment options for BPH?
Men with mild BPH symptoms may be effectively treated with medication, supplements, and/or lifestyle changes. As some medications (such as decongestants or antihistamines) can affect your prostate, your doctor may advise you to refrain from using them. The downsides to medical treatment are common side effects including dizziness and nausea.
More severe BPH symptoms have traditionally been managed with transurethral resection of the prostate (TURP), a surgically invasive procedure that requires anesthesia. Unfortunately, side effects are common with TURP procedures and include infection, sexual dysfunction, and retrograde ejaculation. Other potential complications include bleeding, which may potentially require transfusions, and overnight hospital admissions.
A revolutionary and minimally invasive treatment option, known as prostate artery embolization (PAE), was approved by the FDA in 2018. This procedure, performed by an interventional radiologist, helps alleviate moderate to severe BPH symptoms for most men without the need for surgery!
What is Prostate Artery Embolization?
Prostate Artery Embolization (PAE) is a minimally invasive treatment option for BPH performed by an interventional radiologist who inserts a tiny catheter into an artery through a pinhole in your upper thigh or wrist and then uses x-ray imaging to guide it through the body’s blood vessels to the arteries that supply blood to the prostate. Tiny beads called ‘microspheres’ are released through the catheter and into the arteries, blocking blood flow to the prostate. Reduced blood flow relieves pressure on the pinched urethra for fast relief of symptoms. No general anesthesia is required for this procedure – only moderate sedation and local anesthesia!
While PAE is extremely effective, the beauty of PAE is if, after trial of PAE, you still require further treatment, then repeat PAE or surgery still remain options. The same cannot be said of conventional surgery.
Complications with this procedure are extremely rare. More common side effects may include pelvic pain, nausea, fever, and temporary discomfort during urination. Since these side effects are mild and inflammatory, appropriate post-procedural medications to prevent or treat these are arranged beforehand.
How do I know if I am a good candidate for PAE?
Prostate artery embolization is recommended for patients who:
- Have an enlarged prostate (greater than 40 grams)
- Have not been able to control their BPH symptoms with medication or wish to avoid medication side effects
- Do not wish to have surgery
- Are not a candidate for surgery due to anesthesia risk or on blood thinners
- Wish to try minimally invasive approach first
- Have refractory hematuria (blood in urine)
- Are on anticoagulants or antiplatelet medications (blood thinners)
- Smoke cigarettes and are therefore poor anesthesia candidates
If you believe you are a candidate for PAE, contact your doctor for next steps and a referral to Vascular & Interventional Specialists. If you have any questions or would like to learn more, give us a call at 817 321 0951, or fill out our contact form, and we would be happy to provide you with more information.
