Prostatic Artery Embolization

 

What is Benign Prostatic Hyperplasia (BPH)?

Benign Prostatic Hyperplasia (BPH) is a urological health problem that primarily affects older men. BPH is characterised by urinary flow obstruction, as well as discomfort and pain. From an etiological and pathogenesis standpoint, BPH is a severe medical complication.

Benign prostatic hyperplasia is a medical condition in which the prostate, a walnut-sized muscular tissue organ, grows in size. The prostate is positioned or located right in front of the rectum and beneath the bladder. As the urethra (tube which carries urine outside the body) passes through the prostate, enlargement of the prostate can prevent, obstruct urine or sperm from passing through the urethra.

Prostate enlargement is a common problem in men. Men are more likely than women to develop prostate enlargement as they get older. By the age of 60, approximately half of all men will have some signs of BPH, and this percentage only rises with age. Approximately half of these men suffering from BPH will develop symptoms which will require treatment.

Symptoms of BPH

Because the urethra passes through and is surrounded by the prostate gland, prostate enlargement can result in urethral tube blockage. As a result, a person may experience the following symptoms of benign prostatic hyperplasia:

  • Dribbling or slowness of urinary stream
  • Difficulty in starting to urinate
  • Frequency of urination
  • Sudden need to urinate
  • Pain after ejaculation or while urinating
  • Urine that looks different, bloody in colour

If ignored or left untreated BPH symptoms can and may lead to:

  • Bladder stones and infection
  • Damage to your kidneys, due to large amounts of extra urine accumulated in the bladder

These symptoms of BPH should not ignored, see your doctor immediately

Treatment of Benign Prostatic Hyperplasia (BPH)

Patients with mild BPH symptoms may only require monitoring and medication to ensure that their condition does not worsen. There are few treatment options for severe BPH symptoms.

Prostatic Artery Embolization

Prostatic artery embolization (PAE) is a cutting edge treatment that aids in the relief of lower urinary tract symptoms caused by enlargement of prostate termed as BPH. Originally developed in Europe, PAE is a minimal invasive treatment without any side effect.

A medical expert, who is intervention radiologist performs the Prostatic Artery Embolization procedure, by using X-rays and other advanced imaging to see inside the body and treat conditions without surgery.

How is prostatic artery embolization (PAE) procedure performed?

To provide a reference point for the surrounding anatomy, a thin, hollow tube held in place with a balloon at the end, known as Foley catheter will be inserted into the urethra and directed in the bladder.

A small puncture in the wrist or groin is made to perform prostatic artery embolization. A catheter is inserted into the artery and guided to the prostate through the puncture. After inserting the catheter into the artery that supplies blood to the prostate, tiny particles are injected, obstructing blood flow and plugging the artery. This is referred to as embolization.

The procedure is repeated on the other side, using the same wrist or groin puncture as before. Depending on the location and size of the prostatic arteries, the procedure can take anywhere from 1 to 4 hours.

In PAE procedure, over a period of time the body's immune system replaces the dead tissue with a scar tissue, which then slowly contracts, leading in shrinking of the prostate, resulting in improvement of the BPH. PAE procedure provides remarkable improvement for men who undergo the procedure.

During the PAE procedure

For the PAE procedure general anaesthesia is not used instead the patient will be injected with IV medications to take the anxiety and pain away making the patient comfortable and relaxed for the PAE procedure.

Who should opt for PAE procedure?

Patients who are either ineligible or not interested in traditional surgery for BPH should opt for PAE procedure. The PAE procedure is suited for patients with a prostate volume of less than 80 mL and is relatively contraindicated in patients with acute urinary retention or with PVR volume greater than 250 ml.

Intervention radiologist will examine and determine if you are a candidate for PAE. He may ask you about the urinary symptoms and pattern and urine test analysis to ascertain the extent of its impact. CT Angiogram of the Pelvis region to study the blood supply to the Prostate. PSA or prostate specific antigen test.

How PAE is different from Other BPH treatment options?

Apart from PAE there are two other major procedures commonly recommended or used to treat BPH.

UroLift

In UroLift procedure a doctor uses small implants to hold the prostate tissue away from the urethra. The limitations with UroLift System is that it is not a one-size-fits-all treatment option for enlarged prostate. Urolift procedure is only effective and suitable for men with smaller prostate glands and is not effective or recommended to those who have a prostate gland.

Transurethral resection of the prostate (TURP)

TURP is a common type of prostate surgery. It is a form of surgery, which brings with it some negative effects like:

  • Temporary difficulty with urination
  • Potential sexual Side effects or dry orgasms
  • Heavy post-operative bleeding

Based on these side effects and limitations in treatment PAE is a safe and attractive alternative to Urolift and TURP. Also the latest results and studies on PAE area are encouraging suggesting that prostate artery embolization may soon become the standard of care for benign prostatic hyperplasia.

Benefits of PAE Procedure

The procedure is not invasive. The minimal invasive, PAE procedure eliminates BPH symptoms of the patient without resorting to surgery, which has inherent risks and downtime. Transurethral resection of the prostate (TURP) which is the most common surgical treatment option for BPH, requires up to two months of downtime and multiple days of hospitalisation. Whereas patients treated with PAE procedure can expect much faster and comfortable recovery along with great improvement in the symptoms. Following the PAE procedure, patients need not to worry about the negative effects of an enlarged prostate.

Common and major side effects of surgical treatment for BPH, are prolonged discomfort and irritation and potential sexual side effects. These are easily avoided with the PAE procedure, which is minimally invasive and effective alternative.

The Other Benefits of PAE procedure are as follows:

  • There are low risk of urinary incontinence
  • Positive and effective results in just few days
  • No need for bladder catheter as in other form of treatment
  • Less pain, irritation and discomfort pre and post PAE procedure

Possible Medical Risks with PAE

There are risks associated with the PAE procedure, just as there are with any other medical procedure. Minor side effects of PAE include blood stains in the urine, stool, or sperm. Blood leakage from the puncture site in the groin or wrist, bladder spasms, but these are minor and resolve on their own or with a short course of medication.

Why Endovascular Clinic for PAE to treat BPH?

Endovascular clinic has experienced and renowned Interventional Radiologist Dr. Bhavesh Popat, dedicated team of specialist doctors to help you get rid away of the sufferings and BPH symptoms. Advanced equipment and state of art infra-structure makes PAE procedure easier and result oriented with little or no side effects.