What is Benign Prostatic Hyperplasia (BPH)?
The prostate is an organ of the male reproductive system, normally about the size of a walnut, that surrounds the urethra. In older men, the prostate can become enlarged, exerting pressure on the urethra and causing difficulties with urination and other symptoms that can negatively impact one’s quality of life.
This condition, Enlarged Prostate, or Benign Prostatic Hyperplasia (BPH), affects more than 50-60% of men in their sixties, 70-80% of men in their seventies, and 90% of men age 80 or older. Although the enlarged tissue in the prostate is non-cancerous, it can obstruct the lower urinary tract and cause a variety of issues.
- Weak or interrupted urination
- Difficulty starting or controlling urination
- Sudden, urgent needs to urinate
- Increased frequency of urination, especially at night
How is Benign Prostatic Hyperplasia (BPH) treated?
In the past, many of the treatments available to men with BPH have been surgical in nature.
We prefer a safer, non-surgical alternative to BPH treatment called Prostate Artery Embolization, or PAE. The procedure is minimally invasive, requires no general anesthesia, and is performed in our office-based laboratory on an outpatient basis, so there is no need for hospitalization. PAE has extremely low complication rates, with no reports of negative effects on sexual function. The procedure itself is so gentle that it requires almost no recovery time, and patients often report symptom relief within two to three weeks.
What is Prostate Artery Embolization (PAE)?
PAE is performed under light sedation. After numbing the area with a local anesthetic, we insert a microcatheter into a tiny incision in the femoral artery. Then, using advanced imaging technologies, we guide it to the artery that supplies the prostate with blood. Once the catheter is in place, we inject small microspheres into the artery to block it, which causes the abnormal growth to shrink, soften and become absorbed into surrounding tissue.
Patients typically report relief from their negative symptoms within two to four weeks.
These procedures are done with moderate sedation at our facility and recovery time is minimal. A closure device is used to seal your artery which decreases recovery time and can cause some bruising or soreness at the access site.
What makes my prostate grow?
Enlargement of the prostate is called Benign Prostatic Hyperplasia (BPH). It occurs when the cells of the prostate gland begin to multiply. These additional cells cause your prostate gland to swell, which squeezes the urethra and limits the flow of urine.
How common is BPH?
BPH is very common. About half of all men between ages 51 and 60 have BPH. Up to 90% of men over age 80 have it.
What causes BPH?
Doctors aren’t sure exactly what makes this happen. Some think it may have to do with normal hormonal changes as you age, but it’s not clear.
Common signs and symptoms of BPH include:
- Frequent or urgent need to urinate
- Increased frequency of urination at night (nocturia)
- Difficulty starting urination
- Weak urine stream or a stream that stops and starts
- Dribbling at the end of urination
- Inability to completely empty the bladder
What can I do if I’m having these symptoms?
In some cases, especially where symptoms are mild, BPH requires no treatment. When treatment is necessary, many men will simply require daily medication(s). If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend endoscopic surgery through the penis or traditional surgery.
In contrast, prostate artery embolization is a minimally invasive outpatient procedure performed through a small needle puncture in the wrist or hip area. Nothing is inserted in the penis. (A collective sigh of relief, yes?)
How is BPH diagnosed?
Your doctor may evaluate your condition by asking you questions about the severity and type of symptoms you have and how much of an impact they have on your daily routine. Other tests such as urine flow study, prostate-specific antigen (PSA) blood test, ultrasound or prostate MRI may be used to confirm the diagnosis
What treatments are there for BPH?
There are several treatment options for symptomatic BPH depending on severity of the symptoms. Most men start with medications. Some of these have side effects. If the symptoms persist or the patient can’t tolerate the medications, urologic procedures can be performed. TURP is considered the “gold standard” procedure. This device is inserted through the penis and the offending portion of the prostate is removed.
Most patients who are candidates for a TURP could also benefit from a less invasive prostate artery embolization procedure (PAE).
Can I do anything to prevent BPH?
Lifestyle changes can’t prevent BPH, but they may still be good for your prostate. For starters, exercise and a heart-healthy diet can help manage your weight, which is great for your prostate. Exercise also helps your bladder empty at a normal rate.
Am I a Good Candidate for PAE?
The way to find out is to make an appointment for a consultation at ECCO. Most patients are eligible for the procedure, but of course we need to perform a full examination to make sure PAE is the most appropriate treatment to relieve your symptoms. If it’s not, we’ll tell you.