Prostate Artery Embolization-PAE for Benign Prostatic Hyperplasia-BPH

Benign prostatic hyperplasia, a noncancerous enlargement of the prostate gland, is the most common benign tumour found in men.

Surgery was the only option until the recent approval of minimally invasive procedures that open the prostatic urethra, and drugs that can relieve symptoms either by shrinking the prostate or by relaxing the prostate muscle tissue that constricts the urethra.

Signs and Symptoms

  1. Difficulty starting to urinate despite pushing and straining (making a great mental or physical effort to do so)
  2. A weak stream of urine and several interruptions in the stream
  3. Dribbling at the end of urination
  4. A sudden strong desire to urinate (urgency)
  5. Frequent urination
  6. The sensation that the bladder is not empty after urination is completed
  7. Frequent awakening at night to urinate (nocturia)

Less common symptoms include:

  • Urinary tract infection
  • Not being able to pee
  • Blood in the urine

Risk Factors

  • Aging
  • Family history
  • Diabetes and heart disease
  • Obesity
  • If you use beta blockers – a type of medication used to treat conditions such as high blood pressure and migraines – you may be more likely to get BPH.
  • Exercise can help lower the risk.

Emergency Conditions

If you can’t pass any urine or see blood in urine, get medical help right away.

Treatments

  1. Watchful waiting: This is an option for those with early-stage disease & minimal symptoms that are not especially bothersome, and no history of diabetes, other health conditions, or family history.
  2. Medication: Types of drugs are used to treat BPH
    • 5-alpha-reductase inhibitors
    • alpha-adrenergic blockers
    • Phosphodiesterase-5 Inhibitors
  3. Surgery
  4. Thermal Treatments: Thermal procedures lessen symptoms by using convective heat transfer from a radiofrequency generator. Transurethral needle ablation (TUNA) of the prostate uses low-energy radio waves, delivered by tiny needles at the tip of a catheter, to heat prostatic tissue.
  5. Prostate artery embolization (PAE): A minimally invasive procedure that can be an effective treatment for benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland. PAE offers several advantages over traditional surgical treatments for BPH.

Surgery causes the greatest number of long-term complications, such as:

  1. Impotence
  2. Incontinence
  3. Retrograde ejaculation: ejaculation of semen into the bladder rather than through the penis.
  4. The need for a second operation (in 10% of patients after five years) due to continued prostate growth or a urethra stricture resulting from surgery.

Benefits of Prostate artery embolization

  1. Minimally invasive: PAE is performed through a small incision in the groyne, with no incisions required in the abdomen or prostate. This reduces the risk of complications such as infection and bleeding.
  2. Outpatient procedure: PAE is typically performed as an outpatient procedure, meaning that patients can go home the same day. This contrasts with traditional surgical treatments for BPH, which often require hospitalisation.
  3. Quick recovery: PAE has a much shorter recovery time than traditional surgical treatments. Most patients can return to their normal activities within a few days.
  4. Preserves sexual function: PAE is less likely to cause sexual side effects, such as erectile dysfunction and retrograde ejaculation, than traditional surgical treatments.
  5. Effective symptom relief: PAE has been shown to be effective in relieving urinary symptoms caused by BPH. In studies, PAE has been shown to improve urinary flow, reduce urinary frequency, and decrease nocturia (the need to urinate at night).

The advantages of PAE over traditional surgical treatments for BPH:

Feature PAE Traditional surgical treatments
Invasiveness Minimally invasive More invasive
Hospitalisation Outpatient procedure Inpatient procedure
Recovery time Quick Longer
Sexual side effects Less likely More likely
Symptom relief Effective Effective

Overall, PAE is a safe and effective treatment for BPH that offers several advantages over traditional surgical treatments. If you are considering treatment for BPH, talk to your doctor about whether PAE may be a good option for you.

Lifestyle changes and at-home remedies

It is important to note that lifestyle changes and at-home remedies should not be used as a substitute for medical treatment.

  1. Lose weight
  2. Eating a well-balanced diet, rich in fruits and vegetables
  3. Stay physically active: Do exercises to strengthen your pelvic floor muscles
  4. Minimise fluid consumption, especially before going out or going to bed.
  5. Stay warm. Cold can make it feel more urgent to pee.
  6. Don’t hold your urine for too long, as it can strain your bladder; Pee when you first feel the urge because it’s easier on your bladder.

Preventions

  1. There is no sure way to prevent BPH.
  2. Still, losing weight and eating a well-balanced diet, rich in fruits and vegetables, may help.
  3. Too much body fat may increase hormone levels and other factors in the blood and stimulate the growth of prostate cells. Staying active also helps control weight and hormone levels.

FAQs

When is BPH treatment necessary?
A progressive decrease in the size and force of the urinary stream and the feeling of incomplete bladder emptying are the symptoms that indicate the need for treatment.
If you have questions regarding treatments for Prostate Artery Embolization-PAE for Benign Prostatic Hyperplasia-BPH, please contact us.