Benign prostatic hypertrophy: January 2013

PROSTRATE ARTERY EMBOLIZATION FOR BPH

Dear All,
Prostate artery embolization (PAE) is a new treatment option for men with benign prostatic hyperplasia (BPH), also known as an enlarged prostate gland. This procedure can greatly reduce BPH symptoms.

Most often, patients are discharged from the hospital 3 hours after the procedure, but sometimes it may be necessary to stay overnight.

If you have questions about this procedure, please contact us at "interventionclinic@gmail.com

Prostatic artery embolization (PAE) offers a potential breakthrough for treating prostatic hypertrophy while potentially avoiding some of the debilitating side effects that often accompany transurethral resection of the prostate (TURP).

Men over 50 are more susceptible to benign prostatic hyperplasia (BPH), which can seriously impact quality of life. With PAE, clinicians use a catheter to inject small microspheres into the arteries that nourish the prostate, blocking the arteries and starving the prostate of its blood supply, eventually shrinking it.

One advantage of PAE is that it can treat even very large prostates, which may limit those who are good candidates for TURP, the current gold standard for BPH treatment. And potential side effects associated with TURP have not been seen with PAE.

"We haven't seen impotence, ejaculatory disorders or urinary incontinence in our patients after prostatic artery embolization,".

Frequently asked questions

What are the most common symptoms of an enlarged prostate?

frequent urination at night
frequent urination that often produces only a small amount of urine
hesitant or interrupted urine stream
leaking or dribbling urine
sudden and urgent need to urinate
weak urine stream
feeling like the bladder is not completely empty after urinating
occasional pain when urinating
having to rush to the bathroom suddenly after the urge to urinate
sometimes complete obstruction when severe

What can I expect during my evaluation for PAE?

Besides a history and physical examination, you will need to fill out a short questionnaire to evaluate the severity of your symptoms. After this, you will meet with the Interventional Radiologist who will discuss your treatment options and pre-procedure tests.

What tests may be needed prior to having the procedure?

An MRI or ultrasound of the prostate may be ordered as well as a short test to evaluate the rate of urine flow. A blood test is needed to insure a safe procedure.

How is the procedure performed?

During the procedure, a small, spaghetti-like catheter is placed via an artery in the right groin into the arteries that supply the prostate. Very small particles are injected into the prostate arteries to decrease blood supply to the prostate, thus reducing its size and symptoms.

Will I need to stay overnight in the hospital?

Most often, patients are discharged from the hospital 3 hours after the procedure, but sometimes it may be necessary to stay overnight.

Will I need a foley catheter or catheter inserted via the penis?

It is routine practice to not place a catheter via the penis.

Do I need to have general anesthesia for the procedure?

Patients are given a sedative medication for the procedure which is similar to a colonoscopy and the patient usually is in a ‘twilight sleep.’ There is no need for general anesthesia. The procedure is not considered painful and some patients elect to have no sedation.

What are the results from the procedure so far?

Results are very promising with greater than 90% of patients seeing extreme improvement. Approximately 7% of patients see moderate improvement and 1-2% may see no improvement.