Enlarged Prostate: Benign Prostatic Hyperplasia

Greg Martin, MD, discusses minimally invasive treatments for enlarged prostate.

Article from Society of Interventional Radiology

Enlarged prostate: Benign prostatic hyperplasia

What is benign prostatic hyperplasia (BPH)?

By the time a man reaches age 50, his prostate has already begun to enlarge. For many men, this does not present any issues. Enlarged prostate, or BPH, symptoms affect approximately 50 percent of men in their 50s and as many as 90 percent in their 70s and 80s. As the prostate gland grows, it can slow or stop the flow of urine from the bladder — also called bladder outflow obstruction. If you have an enlarged prostate with bladder outflow obstruction, this is categorized as lower urinary tract symptoms (LUTS). Your symptoms may include frequent urination, the urgency to urinate, poor urine stream and incomplete emptying of the bladder. Your doctor will diagnose enlarged prostate after a detailed exam to rule out other possible causes of LUTS and by reviewing the results of laboratory tests.

How does IR treat enlarged prostate?

While there are other treatments for enlarged prostate, there are many interventional radiologists who can provide an innovative treatment called prostate artery embolization (PAE) to reduce the size of the prostate and relieve the bothersome lower urinary tract symptoms. PAE is a minimally invasive treatment that has less risk, less pain and less recovery time than traditional surgery and that does not carry the risk of sexual side effects typically associated with invasive surgeries.

Through image guidance, an interventional radiologist makes a tiny incision in either the groin or the wrist to insert a small, thin tube called a catheter into an artery and directs it to the blood vessels of the prostate. Once there, the IR blocks the blood flow to specific areas of the prostate, depriving those prostate cells of oxygen and resulting in the gland’s shrinkage.

Men who have undergone PAE have reported high satisfaction and no urinary incontinence or sexual side effects. The only external sign that they underwent treatment is a small puncture mark on the groin or wrist. Minor side effects, most of which resolve on their own, include frequent and/or difficult urination, pelvic pain, blood in the urine, blood in the stool and diarrhea.

Is prostate artery embolization safe and effective?

PAE is a safe and effective treatment option for appropriately selected patients, particularly those who cannot tolerate surgery or have failed other medical therapy; older patients with multiple conditions; patients with very large prostates; patients with bleeding from the prostate or with long-term bladder catheters; patients who cannot stop anticoagulation therapies; and patients who desire to preserve sexual function.

More than 20 studies including over 2,000 patients with moderate to severe LUTS due to BPH show that PAE has shorter recovery and fewer complications than traditional surgery and improves symptoms and quality of life to a greater degree than medical therapy. Read the Society of Interventional Radiology’s multisociety position statement about the safety and efficacy of PAE.

Disclaimer: SIR is providing this information as a public service. SIR assumes no liability — legal, financial or otherwise — for the accuracy of this information or the manner in which it is used. SIR does not offer medical advice. This information is being provided for informational purposes only

https://www.sirweb.org/patient-center/conditions-and-treatments/enlargedprostate/

(photo: prostate, prostatic artery embolization)