New Treatment for Prostate Enlargement

Prostatic artery embolization eliminates side effects associated with traditional treatments

March 29, 2019

For men over 60, benign prostatic hyperplasia (BPH)—more commonly known as prostate enlargement—is a common and uncomfortable condition. Most patients experience urinary frequency, urgency, and even retention. Until recently, treatments involved either medication or surgery, both of which come along with a host of side effects that include dizziness, bleeding, erectile dysfunction, and urinary incontinence. 

Refined over the past decade, there is a little-known third option offered by interventional radiologists for men with prostrate enlargement. Called prostatic artery embolization (PAE), the procedure involves little more than a skin nick and catheterization. 

PAE is an image-guided procedure, which means that interventional radiologists use X-ray and other imaging techniques to guide catheters to the exact area of the body being treated. With PAE, a catheter is inserted through a tiny incision in the patient's wrist or groin and guided to the blood vessels that feed the prostrate. Then, tiny round particles are injected into the blood vessels, reducing the blood flow to the prostate. The entire procedure takes about one hour to perform and patients go home the same day.

With blood supply reduced, the prostate begins to shrink, relieving pressure on the urethra. Men usually see their symptoms relieved within days of the procedure.  

Recovery time is minimal because there is no invasive surgery involved. 

"Patients have been extremely happy with their results," says David Sperling, MD, associate professor of radiology at Columbia University Irving Medical Center. "One patient told us that during a typical round of golf, he would need to stop either every hole or every other hole to urinate.  Now he can go an entire round of golf without stopping."

Prostate enlargement affects approximately 50 percent of men between the ages of 51 and 60. By age 80, the likelihood of having prostrate enlargement will have reached nearly 90 percent. With nine out of ten men anticipating some symptoms due to enlarged prostate in their lifetimes, eliminating the side-effects associated with treatment changes the picture.

"PAE has only been around for eight or nine years," says Dr. Sperling. "Only recently has it been acknowledged as an excellent and safe option for patients based on multiple papers that have been published on the topic. It takes time for patients and doctors to adopt it as a standard option for treatment of benign prostatic hyperplasia." Recent studies have shown that close to 90 percent of patients demonstrate improvement after PAE, with many patients showing up to ten years of good long-term results.