Enlarged prostate: benign prostatic hyperplasia
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH) is the non-cancerous growth of the prostate gland, which is found near the bladder, affecting approximately 50 percent of men in their 50s and as many as 90 percent in their 70s and 80s. With this condition, the total number of cells within the prostate gland increases, either through an increase in cell growth and/or decrease in normal cell death. As the prostate gland grows, it can slow or stop the flow of urine from the bladder--also called bladder outflow obstruction. BPH and bladder outflow obstruction can be categorized as lower urinary tract symptoms (LUTS). Symptoms of LUTS include frequent urination, urgency to urinate, poor urine stream and incomplete emptying of the bladder. Diagnosis of BPH includes a detailed exam to rule out other possible causes of LUTS, as well as laboratory tests.
While there are other treatments for benign prostatic hyperplasia, board-certified interventional radiologists provide individuals suffering from BPH an innovative treatment called prostatic artery embolization (PAE), 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.
Prostatic artery embolization
Prostatic artery embolization is a new approach for the treatment of lower urinary tract symptoms. Through image guidance, an interventional radiologist makes a tiny incision in either the groin or the wrist to insert a catheter into an artery and directs the small tube to blood vessels of the prostate. Once there, the interventional radiologist blocks the blood flow to specific areas of the prostate, depriving those prostate cells of oxygen and resulting in shrinkage of the prostate gland.
Patients who undergo PAE have reported high satisfaction, 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 include frequent and/or difficult urination, pelvic pain, blood in the urine, blood in the stool and diarrhea. Most of these side effects resolve on their own.
The Society of Interventional Radiology's position statement on PAE for BPH notes that PAE, a novel and promising therapy, appears safe and efficacious based on short-term follow-up. Patient satisfaction is high, and repeat intervention rates are low. The PAE procedure is technically challenging, with a possibility of complications if it is not performed meticulously. Interventional radiologists, given their knowledge of arterial anatomy, experience with microcatheter techniques, and expertise in other embolization procedures, are the specialists best suited for the performance of PAE. SIR supports the performance of high-quality clinical research to expand the numbers of patients studied, to extend the duration of followup, and to compare the PAE procedure against existing surgical therapies.
Search clinicaltrials.gov for currently enrolling or future trials of prostate artery embolization for the treatment of enlarged prostate.