Enlarged prostates are a frequent condition among older men. Men with untreated enlarged prostate may experience increasing urinary frequency, urgency, and nocturia, which can severely disrupt daily activities and sleep. One such less invasive but promising alternative to conventional surgical procedures is prostate artery embolisation. This technique offers several benefits, including a lower risk of complications, minimal recovery time, and preservation of sexual function compared to traditional surgical methods. It provides an effective alternative for patients seeking relief from the burdensome symptoms associated with an enlarged prostate.

What is an enlarged prostate?

An enlarged prostate is a common problem in old age, which implies that there is a non-cancerous growth of the prostate gland. Hence, it may be associated with lower urinary tract symptoms such as:

frequent urination
weak urine stream
incomplete emptying of the bladder

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, commonly affecting older men. It can lead to urinary symptoms like frequent urination, difficulty starting urination, and weak urine flow. BPH results from hormonal changes and can be managed with medications, lifestyle changes, or surgery if necessary.

Among the various available treatment options, prostate artery embolisation (PAE) has evolved as a very promising minimally invasive treatment alternative.

What is Prostate Artery Embolisation (PAE)?

Prostate Artery Embolisation (PAE) represents a procedure tailored to ease symptoms of BPH by precisely targeting the blood supply and nourishing the enlarged prostate gland.

In this innovative procedure, a skilled interventional radiologist inserts a catheter through an artery in the groin, guiding it to the specific arteries that supply blood to the prostate.

Here, minuscule particles are delicately introduced through the catheter into these arteries, effectively obstructing the blood flow to the prostate tissue - a complex process known as embolisation.

How does PAE work?

The goal of PAE is to shrink the prostate gland by reducing its blood supply. By depriving the enlarged prostate tissue of blood, PAE induces a gradual size reduction, relieving pressure on the urethra and improving urinary symptoms over time.

Unlike traditional surgical methods such as transurethral resection of the prostate (TURP), PAE does not involve cutting or removing tissue from the prostate, leading to potentially fewer side effects and a quicker recovery.

What are the benefits of Prostate Artery Embolisation?

Let’s explore some benefits of PAE:

Minimally invasive: PAE is performed through a small incision in the groyne, reducing the risk of complications compared to traditional surgery.
Preservation of sexual function: Unlike some surgical treatments, PAE typically preserves sexual function, as it does not affect nerves surrounding the prostates that are critical for erectile function.
Quick recovery: Patients undergoing PAE often experience shorter hospital stays and faster recovery times compared to surgical alternatives.

Who is a suitable candidate for PAE?

PAE may be suitable for men who:

Have moderate-to-severe urinary symptoms from BPH.
Seek a minimally invasive treatment option.
Wish to preserve sexual function.

Risks and Considerations

While PAE is generally safe, like any medical procedure, it carries certain risks, including:

Some patients may experience temporary difficulty urinating or increased urinary frequency immediately following PAE.
As with any invasive procedure, there is a small risk of infection or bleeding.

Conclusion

Prostate artery embolisation (PAE) represents a significant advancement in the treatment of enlarged prostates, offering a minimally invasive alternative to traditional surgical options. With its ability to reduce prostate size and alleviate bothersome urinary symptoms while preserving sexual function, PAE has gained attention as a viable treatment option for many men. As with any medical decision, individuals considering PAE should consult with a qualified healthcare provider to determine if this procedure is suitable for their specific condition and overall health.

Frequently Asked Questions About Prostate Embolization

Q. How effective is PAE in treating enlarged prostates?
A: PAE has shown effectiveness in reducing prostate size and improving urinary symptoms in many patients. Studies indicate significant symptom relief and prostate size reduction comparable to traditional surgical methods.

Q. What are the benefits of PAE compared to traditional surgery?
A: PAE offers benefits such as a minimally invasive procedure with a lower risk of complications, preservation of sexual function, and quicker recovery times compared to surgical options like transurethral resection of the prostate (TURP).

Q. How long does it take to recover from PAE?
A: Most patients recover quickly from PAE, with many returning to normal activities within a few days to a week. Improvement in urinary symptoms may be gradual over several weeks as the prostate gland shrinks.

Q. What is the success rate of PAE?
A: The success rate of prostate artery embolisation (PAE) varies but generally shows significant improvement in urinary symptoms and quality of life in about 70–90% of patients.

Q. Are there alternatives to PAE for treating enlarged prostates?
A: Yes, alternatives include medications for symptom relief, traditional surgical procedures like TURP or laser surgery, and newer techniques such as water vapour thermal therapy. The choice of treatment depends on factors like symptom severity, overall health, and patient preference.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384402/
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/prostatic-artery-embolization