Prostate Artery Embolization (PAE): Enlarged Prostate Treatment 

An enlarged prostate caused by the gradual growth of prostate cells and not infection or malignancy is known medically as benign prostatic hyperplasia (BPH). The excess prostate tissue surrounds and constricts the urethra, causing the following symptoms:

• Difficulty urinating
• Weak urine stream
• Urgent need to urinate
• Frequent urination (primarily at night)
• Feeling that the bladder isn't empty after urinating
• Halting urination (urine stream stopping and starting)

BPH occurs overwhelmingly in men over the age of 50. Symptoms of BPH can be highly uncomfortable and disruptive, causing unwelcome lifestyle changes and making healthy sleep patterns difficult to maintain.

What is PAE treatment for an enlarged prostate?

Prostate artery embolization (PAE) is a non-surgical procedure that has gained attention as a potential alternative to traditional BPH treatments.

PAE involves using tiny particles to cut off blood flow to the prostate tissues, causing the gland to shrink in size. This intervention is executed by an interventional radiologist, using image-guided techniques to navigate through the blood vessels and reach the arteries that supply blood to the prostate. Once the appropriate arteries are identified, small particles are injected to block them, reducing blood to the prostate.

The decreased blood supply to the prostate results in the shrinkage of the gland, relieving the urinary symptoms associated with BPH. PAE effectively reduces prostate size and improves many patients' urinary symptoms. It is considered a safe and well-tolerated approach with a low risk of complications.

One of the advantages of PAE is its minimally invasive nature, which means it can be performed without the need for general anesthesia and with a shorter recovery time compared to traditional surgical treatments for BPH. Additionally, PAE has been found to have a minimal risk of erectile dysfunction (ED) or other sexual side effects, which can be a concern with other treatments.

While PAE is a promising treatment option for BPH, it is important to note that not all patients may be suitable candidates for this procedure. It is recommended to discuss the procedure with a healthcare professional specializing in PAE to determine if it is the right choice based on individual circumstances.

Are there other enlarged prostate treatments?

Other enlarged prostate treatment options include the following:

Monitoring

In cases where the symptoms of BPH are mild and do not cause significant discomfort or complications, a doctor may recommend watchful waiting. This approach involves regular monitoring of symptoms and periodic check-ups to ensure that the condition is not worsening.

Medications

Two categories of medications – alpha-adrenergic blockers and 5-alpha reductase inhibitors – address BPH. 5-alpha reductase inhibitors prevent the conversion of testosterone into dihydrotestosterone, the hormone responsible for prostatic cell growth. Alpha-adrenergic blockers relax prostate smooth muscle tissue, making urine flow easier and more comfortable.

Medications must be taken indefinitely. Many patients experience a return of symptoms over time, and some medications – notably, alpha-adrenergic blockers – can trigger cardiovascular events and other side effects.

Thermal Interventions

Thermal interventions are non-surgical procedures that do not require hospitalization or general anesthesia. These treatments might require multiple sessions.

• Transurethral microwave thermotherapy (TUMT): This intervention is a minimally invasive procedure that involves introducing microwave energy through the urethra to the enlarged prostate tissue. The energy destroys the excess cells causing the blockage of the urethra, relieving symptoms over time.
• Transurethral needle ablation (TUNA): This intervention, like TUMT, uses radiofrequency energy to destroy prostate tissue via the urethra through ultrasound guidance. TUNA, however, uses a lower level of radiofrequency energy than TUMT and penetrates more deeply and precisely into the prostatic tissue.

Surgery

Surgical options for BPH include the following interventions:

• Transurethral resection of the prostate (TURP): The TURP procedure involves the introduction of a narrow, tube-like instrument called a resectoscope into the urethra through the penis. The resectoscope has a light, a camera, and a small wire loop at the end. This loop is used to trim away excess prostate tissue that is obstructing the flow of urine. It is important to note that TURP may also entail some potential risks and complications, such as bleeding, infection, urinary incontinence, retrograde ejaculation, and erectile dysfunction.
• Transurethral incision of the prostate (TUIP): TUIP is a minimally invasive intervention, typically performed under general anesthesia or spinal anesthesia. The surgeon creates one or two incisions in the prostate tissue, helping to relieve the pressure on the urethra and improve urine flow. Unlike other prostate surgeries, TUIP does not involve the removal of prostate tissue; it focuses on widening the urethra passage to alleviate symptoms.

Dr. Lie - Prostate Artery Embolization

Why is PAE a better treatment solution than surgery?

One of the key advantages of PAE is its minimally invasive nature. Unlike TURP, which requires surgery and the removal of prostate tissue, PAE is a non-surgical procedure. The minimally invasive nature of PAE means that patients experience less pain, have a shorter hospital stay, and recover more quickly than TURP.

Another benefit of PAE is its lower risk of complications. TURP carries a risk of bleeding, infection, urinary incontinence, and sexual dysfunction. In contrast, PAE has been shown to have a lower risk of complications. PAE has been found to have a lower risk of erectile dysfunction compared to TURP.

Furthermore, PAE has been shown to preserve ejaculation in men, which is not the case with TURP. This is an important benefit for patients who wish to maintain their fertility.

Additionally, PAE is a suitable treatment option for BPH patients who are not ideal candidates for surgery. Patients who are elderly, have multiple medical conditions, or have previously undergone prostate surgery may find PAE to be a safer alternative.

PAE can be performed under local anesthesia, reducing the risks associated with general anesthesia generally required for TURP.

Georgia Prostate Institute: North Georgia's Leading Prostate Care Specialists

Georgia Prostate Institute's commitment to expertise, cutting-edge technology, comprehensive diagnostics, multidisciplinary treatment options, and patient-centered care has established its reputation as a leading provider of BPH treatments. Our expert team is on the cutting-edge of PAE research and is committed to providing long-term relief from BPH symptoms and improving patients' quality of life.

To schedule an evaluation, please contact our helpful representatives today.