Minimally invasive breakthrough for men’s enlarged prostates improves symptoms

A new interventional radiology treatment that blocks blood supply to men's enlarged prostate glands shows comparable clinical results to transurethral resection of the prostate (or TURP), considered the gold standard (or most common) treatment. However, this minimally invasive treatment- prostatic artery embolization- has none of the risks associated with TURP, such as sexual dysfunction, urinary incontinence, blood loss and retrograde ejaculation, noted researchers at the Society of Interventional Radiology's 36th Annual Scientific Meeting in Chicago.

"Benign prostatic hyperplasia or BPH is so common that it's been said that all men will have an enlarged prostate if they live long enough. I believe that a minimally invasive interventional radiology treatment- prostatic artery embolization or PAE- will be the future treatment for benign prostatic hyperplasia or men's noncancerous enlarged prostates," noted João Martins Pisco, M.D., chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal. "Prostatic artery embolization blocks blood supply to treat noncancerous benign prostatic hyperplasia. This study is significant because it shows comparable clinical results to transurethral resection of the prostate or TURP- without the risks of surgery, such as sexual dysfunction, urinary incontinence, blood loss and retrograde ejaculation (or entry of semen into the bladder)," added Pisco, who is a professor at the Faculty of Medical Sciences, New University of Lisbon. "While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical results- without TURP's limitations and risks," said Pisco. The interventional radiologist indicated that PAE patients experienced symptom improvement comparable to TURP; however, certain urodynamic results (such as flow rate of the urinary stream) did not improve as much as with TURP.

TURP can be performed only on prostates smaller than 60 cubic centimeters (cc); there is no size limitation for PAE treatment, said Pisco. "The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms," he added. "Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anaesthesia," said Pisco.

BPH is not cancer; it is a condition that affects a man's prostate, a gland found between the bladder and the urethra. As a man ages, the prostate gland slowly grows bigger (or enlarges) and may press on the urethra and cause the flow of urine to be slower and less forceful. BPH is characterized by urinary frequency, urgency, passing urine more often (particularly at night), weakened stream and incomplete bladder emptying. "Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment," said Pisco. "We need innovative technologies, such as prostatic artery embolization, to continue to improve outcomes and minimize patient discomfort and morbidity when managing enlarged prostates," he added.