Prostate Artery Embolization
Prostate artery embolization (PAE) is a new treatment option for men with benign prostatic hyperplasia (BPH), also known as an enlarged prostate gland. This minimally invasive procedure can greatly reduce BPH symptoms, without the side effects of traditional prostate surgery.
During the procedure, a small, spaghetti-like catheter is placed via an artery in the right groin into the arteries that supply the prostate. Very small particles are injected into the prostate arteries to decrease blood supply to the prostate, thus reducing its size and symptoms.
Most often, patients are discharged from the hospital 3 hours after the procedure, but sometimes it may be necessary to stay overnight.
What are the most common symptoms of an enlarged prostate?
- Frequent urination at night
- Frequent urination that often produces only a small amount of urine
- Hesitant or interrupted urine stream
- Leaking or dribbling urine
- Sudden and urgent need to urinate
- Weak urine stream
- Feeling like the bladder is not completely empty after urinating
- Occasional pain when urinating
- Having to rush to the bathroom suddenly after the urge to urinate
- Sometimes complete obstruction when severe
Transurethral resection of the prostate (TURP) is a type of prostate surgery. During a TURP procedure, a surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the resectoscope, your doctor trims away excess prostate tissue that’s blocking urine flow and increases the size of the channel that allows you to empty your bladder. TURP is one of the most effective options for treating urinary symptoms caused by BPH. To determine whether TURP or another treatment is the right choice for you, your doctor will consider how severe your symptoms are, what other health problems you have, and the size and shape of your prostate.
Also known as Photoselective vaporization of the prostate (PVP), this is a minimally invasive method of treating BPH. One commercially known device is the greenlight laser. During laser PVP surgery, a catheter with a camera system (cystoscope) is inserted into the penis. A urologist places a laser through the cystoscope to burn away (vaporize) excess prostate tissue. This may ease the blockage of the urethra and enlarges the opening to allow better urine flow during urination. This can be effective therapy, but may not be as durable and long lasting as TURP.
Prostate Artery Embolization
In this outpatient procedure, interventional radiologists insert a spaghetti sized catheter into a leg artery (femoral artery) in the groin area and guide this catheter to the prostate arteries. A material may be injected in the artery, if deemed appropriate, to block the blood vessels going to the hypervascular nodules that form in Benign Prostatic Hyperplasia (BPH). These nodular growths are also called prostatic adenomas. By blocking the blood vessels to the nodular growths, the prostate may shrink and thereby reduce the blockage of urine and pressure on the bladder. Catheters or probes are not routinely placed through the penis for this procedure. To determine whether you are candidate for this procedure as part of routine medical practice, your doctor will discuss how severe your symptoms are, what other health problems you have, and the size and shape of your prostate. The embolic material that is injected in to the arteries (embolic material) is not FDA approved for the specific indication of treatment of an enlarged prostate/BPH and its use is considered off label by the FDA.
Transurethral microwave therapy (TUMT) is usually an outpatient procedure where a small microwave antenna is inserted through the tip of your penis into the tube that carries urine from your bladder (urethra) until he/she reaches the inside of the prostate. The antenna emits a dose of microwave energy that heats up and destroys excess prostate tissue blocking urine flow.
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