Men: Manage enlarged prostate symptoms without the risk of ED
July 25, 2018
Twenty years ago, the only treatment doctors could offer for enlarged prostate (benign prostatic hyperplasia, or BPH) was transurethral resection of the prostate (TURP). While effective, TURP is invasive and can result in complications that scare men, namely erectile dysfunction and retrograde ejaculation, or ejaculation back into the bladder instead of out of the body.
But today, Dallas patients with BPH can breathe a sigh of relief. UT Southwestern is among a select number of medical centers in the U.S. to offer a less invasive and equally effective treatment called prostate artery embolization, or PAE. This procedure offers men lasting relief from BPH symptoms, which include:
- Frequent, painful urination
- Inability to completely empty the bladder
- Urgent urination
BPH symptoms can affect a patient’s relationship and performance at work due to difficulty sleeping through the night or needing frequent bathroom breaks during the workday or while traveling. Let’s discuss how prostate artery embolization can improve patients’ BPH symptoms and quality of life.
What is prostate artery embolization?
The main function of the prostate gland is making fluid that goes into the semen. An enlarged prostate can block the flow of urine through the urethra. The condition starts to become more common after men turn 40.
The prostate gland is located below the bladder and in front of the rectum, making it difficult to reach for surgery. TURP surgery involves inserting a surgical instrument through the penis and resecting the prostate, which increases the risk of sexual dysfunction. However, PAE allows us to make a small incision in the groin or an artery in the arm or groin instead, which is much less invasive. A tiny catheter (tube) is navigated under imaging guidance into the blood vessels of the prostate, and tiny microparticles are injected to decrease blood supply to the prostate, thus reducing its size and symptoms.
PAE can be performed for patients under full anesthesia or partial sedation. We discharge our patients after one night of hospital stay. We generally ask patients not to eat six hours or drink four hours before the operation. The procedure itself usually takes three to four hours.
How do we know PAE is successful?
Research shows PAE has good success rates in the short- and long-term. One study evaluated 1,000 men (average age of 67) who had enlarged prostates and received PAE between 2007 and 2016. All participants were assessed in the short term (at one, three, and six months); 807 patients were seen through the medium term (every six months between six months and three years); and 406 patients were evaluated in the long term (every year after three years).
During each evaluation, researchers assessed each patient’s peak urinary flow rate, prostate size, ability to empty the bladder, and erectile dysfunction. From the data, the researchers found the following cumulative success rates regarding the treatment of these symptoms:
- 89 percent at the short-term mark
- 82 percent at medium-term mark
- 78 percent at the long-term mark
At UT Southwestern, we measure successful PAE treatment through patient surveys, asking men to describe the severity of their symptoms before and after surgery. A decrease in symptoms is considered successful.
Who’s most likely to develop BPH?
Men who are most likely to develop BPH are:
- Older than 40
- From a family with a history of prostate conditions
- Heart or circulatory disease patients
- Diagnosed with Type 2 diabetes
- Not physically active
Aging and family history are significant factors for developing an enlarged prostate. One way to reduce the risk is to live a healthy lifestyle in general, eating fruits, vegetables, and foods rich in omega-3 fatty acids – found mostly in fish, walnuts, and flaxseeds – exercising regularly, and maintaining a healthy weight.
Living with an enlarged prostate can greatly affect a man’s quality of life. Prostate artery embolization can make a world of a difference for BPH patients and their partners, providing relief and a reduced risk of sexual complications.