Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. It is a common condition affecting older men. Based on latest research and studies, approximately 30 million men in India are believed to be affected by BPH. The prevalence is expected to rise as the population ages, with BPH becoming more common in men over 50 years of age.
As the prostate enlarges, it can compress the urethra, thus a person suffering from BPH may experience painful and uncomfortable urinary symptoms such as frequent urination, a weak stream, and trouble in emptying the bladder.
Some men have minor symptoms that can be easily controlled or managed with medicine or lifestyle modifications, but others have more severe symptoms that substantially impact their quality of life.
If you encounter any of the aforementioned symptoms, then see the doctor right away. He will diagnose you and determine the appropriate course of action depending on the severity of the illness.
In addition to the standard treatment for BPH, prostate artery embolization (PAE) has emerged as a minimally invasive treatment alternative. In this article we will look at the effectiveness, advantages, and side-effects of PAE in treating BPH.
The traditional treatment options for BPH include:
Medication: To treat BPH symptoms, doctors often use alpha-blockers and 5-alpha-reductase inhibitors. However, patients may not experience full relief from these drugs, and they will require long term adherence to these medicines.
Surgery: The two most common and standard surgical procedures for benign prostatic hyperplasia treatment (BPH) are transurethral resection of the prostate (TURP) and laser therapy. Even though they are effective, these procedures may carry some risks like bleeding, infection, etc. and may require longer recovery period.
Patients for whom surgery might not be conducive or who would not want to go for long treatment procedures, may find that Prostate Artery Embolization (PAE), a novel and minimally invasive alternative, as a good option.
What Is Prostate Artery Embolization (PAE)?
PAE is a non-surgical, image-guided technique performed by specialist called Interventional Radiologists. In this procedure the blood supply to the enlarged prostate is cut off, causing the prostate to shrink and thereby providing relief from the symptoms of BPH.
Here is the detailed explanation of how the PAE procedure is performed:
Preparation and Local Anesthesia: Local anaesthetic is administered to the patient to numb the groin area where a catheter will be implanted.
Catheter Insertion: The radiologist uses a tiny catheter to reach the arteries that feed blood to the prostate via a small puncture in the femoral artery in the groin or the radial artery in the wrist.
Embolization: Once the prostate arteries have been detected using X-ray imaging, then tiny, microscopic particles (often made of synthetic material) are injected into the catheter to block them, shutting off blood flow to the prostate. This gradually reduces the size of the prostate, easing strain or pressure on the urethra.
Recovery: After the procedure, most of the patients are able to return home the same day or the next day with little or no discomfort. Full recovery and apparent symptom reduction typically take few weeks to subside as the prostate gradually shrinks.
Effectiveness of PAE
Numerous studies have shown that PAE is beneficial in treating BPH symptoms, especially in patients who are not conducive for surgery, invasive procedures or prefer to avoid long term medication process.
Symptom Relief: Clinical research has found that PAE can dramatically improve BPH symptoms. In one study, 80-90% of patients reported improved symptoms within 3 months of the PAE procedure. Symptom improvement includes improved urine flow, urinary frequency, and less nocturnal urination (nocturia).
Prostate Size Reduction: PAE causes a significant reduction in prostate volume, usually between 20% and 40%. As the prostate shrinks, pressure on the urethra decreases, allowing for better urine function.
Durability of Results: One of the primary concerns with any medical intervention is the long-term benefit of the procedure. According to research, PAE provides long-lasting relief, with many patients reporting continuing symptom improvement for up to five years after the surgery.
Advantages of PAE Over Traditional Treatments
PAE has numerous distinct advantages over more invasive surgical therapies such as TURP or laser therapy.
Fewer Side Effects: One of the primary advantages of PAE is the lower likelihood of complications, particularly those involving sexual function. Traditional operations like TURP and laser therapy might cause sexual side effects such as retrograde ejaculation and erectile problems. In comparison, PAE has a substantially reduced incidence of such adverse effects, making it an appealing choice for sexually active males.
Quicker Recovery: Because PAE is a minimally invasive technique, it takes less time to recover than other surgical procedures. Most patients can return to normal activities within a few days, although standard surgery can take weeks.
Repeatability: Another benefit, good point of PAE is that treatment can be repeated as needed. This is especially advantageous for individuals who have a recurrence of symptoms, as some BPH therapies, such as TURP, can be more difficult in repeat procedure.
Suitable for High-Risk Patients: Patients with additional medical complications (such as cardiovascular disease or diabetes) that can make surgery problematic can have PAE performed successfully. This technique carries fewer chances or risks of bleeding, infection, and anesthesia related problems.
Potential drawbacks and risks involved in PAE procedure.
While PAE is typically safe and effective, like all other medical procedure, it does have some complications and limitations. Understanding these limitations is critical for making an informed treatment selection.
Not effective for all patients: PAE may not be the best solution for males with very big prostates or having certain anatomical variants. In rare circumstances, accessing the prostate arteries can be difficult, reducing the procedure’s effectiveness.
Possible Complications: While they are rare, complications such as blood clots, urinary tract infections, or unintentional embolization of non-target areas (such as the bladder or rectum) can occur. However, these risks are minimal when the procedure is performed by experienced Interventional Radiologists.
Prostate Artery Embolization is a viable, minimally invasive treatment for Benign Prostatic Hyperplasia that has several advantages over traditional surgical treatments. Though negligible, yet like with any medical procedure, PAE can also have some drawbacks. Patients should talk with their healthcare experts to see if PAE is the best solution for their particular problem. With a growing amount of clinical research supporting its safety and efficacy, PAE is expected to become a more commonly accepted treatment for BPH in the coming years.
