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As men get older, many of us find that we have to use the bathroom more often than we used to or get up more frequently in the middle of the night to go. These are common signs of benign prostatic hyperplasia (BPH), also known as an enlarged prostate. The prostate is a walnut-sized gland in the male reproductive system that can enlarge and put pressure on the bladder and urethra, causing urinary symptoms such as:
- Trouble emptying the bladder
- Urgent need to pee
- Weak urine stream
As many as 60 percent of men in their 60s have symptoms of BPH, as do up to 90 percent of men in their 70s and 80s. Many men are wary of BPH treatments because they can cause side effects such as headaches, nausea or inability to maintain an erection. But in 2017, the FDA approved a new procedure called prostatic artery embolization that can provide relief from symptoms in about 90 percent of men—without causing unpleasant side effects.
LISTEN: Dr. Sabri and Dr. Horton discuss prostate artery embolization for enlarged prostate in the Medical Intel podcast.
How does prostatic artery embolization work?
Once you come into our clinic, we’ll do several tests to make sure you’re a good candidate for prostatic artery embolization. A good candidate for prostatic artery embolization:
- * Wants to preserve normal sexual function
- * Doesn’t want BPH surgery or isn’t a candidate
- * Doesn’t respond well to BPH medications
- * Doesn’t want to or no longer can use catheters (small tubes inserted in the penis to urinate)
First, we have to make sure you don’t have prostate cancer, which has many of the same symptoms as BPH. We also need to perform tests on your urine, such as how strong your stream is, to make sure the procedure will benefit you.
On the day of your procedure, you’ll be given a sedative and local anesthetic, but you won’t be asleep. We’ll make an incision in an artery in your upper thigh and insert a catheter. Using X-ray images to guide us, we’ll thread the catheter into the arteries that bring blood to the prostate. Next, we’ll release tiny particles through the catheter and into the arteries. These particles, about the size of grains of sand, decrease the amount of blood that comes to the prostate. The procedure takes just a couple of hours, and you can go home afterward once we make sure you are OK. The prostate will begin to shrink because of its decreased blood supply. This will put less pressure on the bladder and urethra, relieving the symptoms of BPH.
Men often start seeing improved symptoms within a few days or weeks after the procedure. In a nine-year study, 78 percent of patients who had the procedure experienced long-term relief of their BPH symptoms. That’s better than or on par with the other minimally invasive therapies that are available today. Among the patients we’ve seen, about 90 percent have had improved symptoms after prostatic artery embolization.
For many men with BPH, prostatic artery embolization provides a much-needed alternative to medications or prostate surgery. If you’re struggling with BPH symptoms, talk to your urologist to find out if this simple procedure can help you find relief.