Blog and News | Northern Beaches Interventional Radiology

Enlarged Prostate Treatment Without Surgery

Written by Shaun Quigley | Jan 11, 2022 2:01:58 AM

For those who have been diagnosed with a condition that causes an enlarged prostate, such as Benign Prostatic Hyperplasia (BPH), the thought of surgery as a treatment option is often a scary one. 

The fear of having to give up their favourite activities, or spending extended time in hospital, or going through the long recovery times that can come from a major surgical procedure may deter many patients from going through with the treatment at all. 

However, there are other options. If you're looking to find out more about non-surgical treatments for an enlarged prostate, this blog post is for you.

 

What is the Prostate?

Let’s start with the basics - the prostate gland is a small, walnut-sized gland located just beneath your bladder and in front of your rectum, which is responsible for producing the semen which nourishes and transports sperm during ejaculation.



What Happens When it Becomes Enlarged?

When your prostate becomes enlarged, which is quite common in older men, it can squeeze the urethra, blocking the easy flow of urine. This can lead to a number of symptoms including:

  • A weak or slow urinary stream
  • Incomplete bladder emptying
  • Frequent or urgent urination
  • Incontinence



Non-Surgical Treatment for an Enlarged Prostate

When it comes to treating enlarged prostates, you have a number of options. 

Lifestyle Changes

For men experiencing mild symptoms, changes to their lifestyle are usually the first steps in reducing the size of their prostate.

These changes can include dietary changes (cutting back on red meat, alcohol and caffeine, among other things), increasing the amount of exercise they do, and removing stress from their life.

 

Medication

Medication is also an option. These include Alpha-1 blockers that relax the neck of the bladder and allow urine to flow easier. They relax your muscles and open arteries, helping reduce blood pressure. Unfortunately, most alpha-blockers need to be taken for life. Common side effects include nausea and lightheadedness, dizziness and headaches.

Antibiotics can also be prescribed if you are suffering from bacterial prostatitis. 

 

Surgery or Minimally Invasive Treatment

To reduce the size of a prostate, there are a few options available to doctors and specialists, such as transurethral resection of the prostate, or TURP for short. This has long been considered the ‘gold standard’ of prostate treatments, but it does require hospital admission and up to 2 nights in a hospital bed. It also comes with extensive recovery time and is considered a major surgery.

Fortunately, a cutting-edge option exists for men who would prefer not to have surgery - Prostatic Artery Embolisation.



Prostatic Artery Embolisation: Enlarged Prostate Treatment Without Surgery

One of the latest treatments being offered for BPH in Australia is Prostatic Artery Embolisation (PAE) - an innovative, minimally invasive procedure used to help improve lower urinary tract symptoms (LUTS) caused by an enlarged prostate. 

It is considered to be a safe and effective method of symptom reduction and has been shown to yield great results: over 90% of men gain symptomatic improvement (decreases in prostate volume and increases in urinary flow rates) following the procedure, and undergoing PAE doesn’t prevent you from undergoing other prostate reduction procedures later on.

 

How is PAE Performed?

PAE is generally done under sedation and a local anesthetic. This makes PAE a viable option for men with complex medical issues who can’t have the general anesthetic required for more invasive treatments.

Following sedation, a tiny tube is inserted into the radial artery in the wrist and guided into the prostate arteries using X-rays. By going through the wrist you’ll recover faster and leave the hospital sooner, although the procedure can also be done via the femoral artery in the groin. 

Then, tiny particles which embolise (block) the arteries are delivered to the area, reducing blood flow to the prostate and causing it to decrease in size in the days, weeks, and months following the procedure. You may feel some minor burning sensations during treatment, but this is normal and rarely too painful. The entire procedure generally lasts 2-3 hours.

Following the procedure, you will need to remain in the hospital for up to two hours for a radial procedure and six hours for a femoral procedure. 

Below is a video from ask4pae.com explaining the procedure:

 

 

Benefits of Prostatic Artery Embolisation

Here are the benefits of choosing PAE:

  • Minimally invasive procedure - it only requires a small incision in your wrist or groin. TURP is considered a major procedure.

  • Typically performed as an outpatient procedure, meaning you won’t need to stay overnight. One study found that 71% of PAE cases were performed as outpatient or day cases, whereas 80% of TURP cases required overnight stays (the majority of which required 2 nights in hospital).

  • When compared to other surgeries, such as TURP, PAE offers a shorter hospital stay and a faster recovery time. PAE patients will usually be back on their feet, engaging in their usual lifestyle activities within a week!

  • PAE comes with a lower risk of negative side effects, especially sexual or incontinence, when compared with other surgery options such as TURP.

  • Can be used without limits on prostate size, urethral narrowing, or bladder capacity. 

  • PAE has a success rate of over 90% - meaning 9 out of 10 men will see significant improvement in their quality of life and reduction of symptoms.

  • Clinical studies have shown that PAE can be just as effective as the ‘gold standard’ TURP but with fewer downsides.



Is It Time for You To Seek Treatment?

While PAE is a suitable option for many men diagnosed with benign prostatic hyperplasia, your perfect treatment plan will depend on a number of factors, but it always starts with the severity of your symptoms.

This is why we’ve created a free health tool to help you understand how severe your prostate problem symptoms are, and when you should seek medical advice.

The International Prostate Symptoms Score is a simple and quick 7 question survey used by doctors, urologists, and interventional radiologists all over the globe to help identify how severe a patient’s symptoms are and design a treatment plan. Complete the survey here so you know exactly when it’s time to seek medical advice.