Prostate Artery Embolization – low invasive method for Benign Prostatic Hyperplasia
The American Urological Association data indicates that the prostate problems (which has many names, like benign prostatic hyperplasia, BPH, enlarged prostate gland) will affect half of the man over 60 years old, and almost 90% of the men aged 85 and more. The statistics are worrying, but if the problem touches almost every elderly male, the medicine must have found an efficient way of treatment. Certainly, waking up twice a night to the bathroom cannot be the only vision of the future.
There are many therapies available, starting from special herb teas, medications, low invasive treatments and the serious surgery. The best method for each patient depends on how severe the symptoms are, the age and general health condition. The place of PAE in the care pathway is between the medications and surgery, allowing the clinician to tailor treatment to individual patients’ requirements, symptoms, and anatomical variation.
Prostate Artery Embolization is one of the most innovative and effective treatments. In some countries, like Portugal or Poland, the procedure became popular, thanks to the low invasiveness. In the UK this kind of treatment is still hardly available (only in major cities) and expensive, but in our southern neighbour countries, there are some high-specialized private facilities, where prostate artery embolization can be achieved at the favourable price.
The surgery itself lasts about 1,5 hour and is performed under a local anesthetization. After the procedure, the patient stays in the clinic overnight.
To understand the idea of prostate artery embolization, we need to get back to the very basics: what is the Benign Prostatic Hyperplasia, and why the enlarged prostate is such an annoying medical affliction. Benign prostate enlargement (BPE) is the condition, where your prostate gland is enlarged, which affects your urine flow. It should neither be connected with cancer, nor with the greater cancer risk.
The prostate, located in pelvis between the bladder and the penis, is the small gland. If usually with ageing, the prostate becomes enlarged (“swollen”), it places the pressure on the urethra, which disrupts the urine flow. This may be a serious obstacle in the daily activities, as you need to pee frequently, and may have difficulties to empty the bladder and to start to urinate.
The Prostate Artery Embolization is performed in order to decrease the prostatic gland size. The idea is, to fulfil the surrounding blood vessels (that nourish the prostate gland) with special molecules (round microspheres, embolization molecules), to reduce the blood supply, and in effect, reduce the prostate.
PAE is usually performed by the experienced vascular surgeon or an interventional radiologist. The prostate artery embolization is performed through a small catheter, which is inserted into the artery in your groin. The doctor will then guide the catheter into the vessels that supply blood to your prostate. It is vital to undergo the angio-CT and the MRI examinations before the procedure, so the doctor could learn the shape and location of the blood vessels of each patient. Tiny particles (embolization molecules) are injected through the catheter and into the blood vessels that feed your prostate to reduce its blood supply. Following this procedure, the prostate gland will begin to shrink, relieving and improving symptoms usually within days of the embolization. Both the right and the left prostatic arteries need to be blocked in this way.
One of the greatest advantages of this treatment, compared with more invasive surgical procedures such as a TransUrethral Resection of the Prostate (TURP), is a lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction). It also doesn’t affect the ability to have children and Patients are happy with the outcome. In our opinion, it is the method definitely worth considering, if you suffer from the prostate hyperplasia.
Do you have any experience with PAE treatment in the UK or abroad? Do not hesitate to share it in comments below.