Prostate Artery Embolization (PAE): Effective Treatment for an Enlarged Prostate

The overgrowth of prostate tissue cells without infection or malignancy is called benign prostatic hyperplasia (BPH). The enlarged prostate gland compresses and tightens the urethra, resulting in the following urinary symptoms

• Problems urinating
• Weak urine flow
• A sudden need to urinate
• Increased need to urinate, particularly during the night
• Having the sensation that the bladder hasn't emptied fully
• Hesitant urine stream (urine stops and starts)

BPH is prevalent among men aged 50 and older. BPH symptoms are often bothersome and unpleasant, resulting in undesirable and often embarrassing lifestyle adjustments and sleep deprivation.

Prostate Artery Embolization (PAE) for BPH

Prostate artery embolization (PAE) is a non-surgical technique that has drawn attention as a viable and highly effective replacement for invasive BPH treatments.

During PAE, a small catheter is passed into an artery in the wrist or the groin and guided to the prostatic arteries using X-ray imaging. Tiny embolic materials are then injected into the prostatic arteries. These particles block the blood supply to the prostate gland, effectively shrinking it.

PAE aims to reduce the symptoms caused by an enlarged prostate without surgery. By restricting the blood flow to the prostate, PAE causes the prostate gland to shrink over time. This approach relieves the pressure on the urethra and improves urinary symptoms.

PAE is performed under local anesthesia and patients can go home the same day. The procedure has a lower complication rate than traditional surgical BPH treatments.

Studies have shown PAE can provide significant relief from BPH symptoms, including improved urine flow and reduced frequency of urination. It is considered a safe and effective alternative to surgery for many men with BPH. However, not all patients are suitable candidates for PAE, and a thorough evaluation by a healthcare professional is necessary to determine if this procedure is appropriate.

Other Treatments for BPH

While PAE is a safe and highly effective solution for most BPH patients, some patients might not be viable candidates for the procedure. Alternative interventions might include the following strategies:

BPH Monitoring

Monitoring BPH involves regular check-ups with a healthcare provider to assess the condition's progression and monitor any changes in symptoms. This approach is often recommended for men with mild to moderate symptoms or those who prefer a conservative management strategy.

Medication Management

Alpha-adrenergic blockers and 5-alpha reductase inhibitors are commonly recommended for treating BPH.

Alpha-adrenergic blockers work by relaxing the smooth muscle in the prostate and bladder neck. This relaxation helps to relieve the obstruction of the urinary flow caused by an enlarged prostate. On the other hand, 5-alpha reductase inhibitors work by preventing the conversion of testosterone to dihydrotestosterone (DHT), a hormone responsible for the growth of the prostate gland.

While medications can alleviate symptoms for many patients, they require continual administration. Moreover, some patients experience cardiovascular complications from alpha-adrenergic blockers.

Transurethral Procedures

Transurethral approaches are techniques that involve guiding a thin tube through the urethra.

Non-Surgical

• Transurethral microwave thermotherapy (TUMT)
  TUMT uses microwave energy to heat and destroy excess prostate tissue. It is usually performed under local anesthesia (though general anesthesia might be recommended for some patients). During the procedure, a specially designed catheter equipped with a microwave antenna is inserted into the urethra, allowing controlled delivery of energy to the prostate. Microwave energy generates heat, which selectively targets and destroys the prostate tissue.
  
  
• Transurethral needle ablation (TUNA)
  TUNA also uses energy to target excess prostatic tissue, but it requires a lower dose than TUMT. The treatment is mainly performed on patients with larger prostates. TUNA is associated with a heightened risk of urinary retention and discomfort post-procedure. Patients might require multiple treatments.

Surgical

• Transurethral resection of the prostate (TURP)
  TURP entails the removal of excess prostate tissue that obstructs the urethra, thus relieving urinary symptoms. During the procedure, a resectoscope, a thin tube with a light and camera at the end, is passed into the urethra and advanced to the prostate. Using specialized instruments, the surgeon carefully removes excess prostate tissue. TURP requires hospitalization for monitoring, as well as the insertion of a urinary catheter.
  
  
• Transurethral incision of the prostate (TUIP)
  This is a surgical technique involving the use of a cystoscope through the urethra. The objective is to widen the prostatic urethra and improve urine flow by making small incisions in the prostatic tissue. The procedure is performed under general or spinal anesthesia.

Prostate Artery Embolization Advantages

PAE offers the following advantages over invasive interventions

• Low risk of complications
• No hospital stay
• Preserves sexual function
• Performed under local anesthesia
• Minimal recovery time

Texas Prostate Institute: Trusted Specialists in Prostate Health

At the Texas Prostate Institute, our team of experienced interventional radiologists is dedicated to providing personalized care and the latest advancements in prostate health. We understand the impact BPH symptoms can have on a man's life, and we strive to offer an effective solution that improves both urinary function and overall well-being.

If you are experiencing symptoms associated with an enlarged prostate and are seeking a non-surgical treatment option, we encourage you to contact our knowledgeable staff to schedule a consultation today.