New non invasive treatment for enlarged prostate

As a man ages, his prostate, the gland that makes the fluid in semen, also grows in size as a response to male hormones such as testosterone. This is usually not a cause for concern unless the prostate, typically the size of a walnut, enlarges to almost the size of a lemon and causes problems like urinary obstruction. A non-cancerous enlargement of the prostate gland is medically referred to as benign prostatic enlargement (BPE) or benign prostatic hyperplasia (BPH).

How an enlarged prostate can cause urinary problems

Located between the bladder and the penis, the prostate gland also surrounds the urethra – the tube that transports the urine from the bladder out of the body. When the prostate gland enlarges beyond a healthy size, it can cause urinary obstruction by increasing the muscle tone at the neck of the bladder and/or by compressing the urethra. Common symptoms of BPE are urinary tract issues such as a sense of incomplete bladder emptying, difficulty in starting urination, frequent urination (including at night, after bedtime), urgency to pass urine, urine leakage, and frequent interruption of the urine stream.

Treating an enlarged prostate

BPE is a lot more common than you think – in fact, it’s estimated that 1 in 2 men aged between 51 – 60 have it. The condition is treatable, but some men avoid seeking help because they’ve heard about the unpleasant side effects of current treatment options. Oral medications prescribed for BPE, such as alpha-blockers, 5-alpha reductase inhibitors and phosphodiesterase-5 inhibitors (specifically tadalafil) can adversely affect a man’s sex life by causing erectile and ejaculatory problems.

Similarly, surgical procedures that reduce the size of an obstructing prostate can cause such side effects. Studies show that many men who have undergone prostate surgery experience an inability to ejaculate during sex. Some experience discomfort during orgasm, while others experience erectile dysfunction.

Left untreated, however, BPE can cause bigger problems. The bladder outlet obstruction due to an enlarged prostate gland can actually lead to irreversible bladder damage. What’s more, when there is bladder failure, surgery for BPE becomes ineffective.

A new option that doesn’t hurt your sex life

Fortunately, there is now a new treatment option for BPE that provides relief from the troublesome symptoms without the side effects of sexual dysfunction. UroLift is a minimally invasive day surgical procedure that involves the use of small permanent implants to draw apart the enlarged prostate tissue which is compressing on and narrowing the urethra within the prostate gland.

UroLift may be recommended for men who want to stop long-term medications for BPE, as well as those who find the side effects of other treatment options unacceptable. If you wish to consider an alternative to conventional treatments, speak to your doctor to find out whether UroLift can benefit you. Note that the prostate can continue to grow after any surgical treatment, so those who have had the UroLift or any other surgical procedures should consult their doctors if their symptoms become distressing as they may need further treatment.

Article contributed by Dr Ronny Tan, urologist at Mount Elizabeth Hospitals

References

At what age do men usually get benign prostatic hyperplasia (BPH)? (May 3, 2019). Retrieved August 27, 2019, from https://www.webmd.com/men/qa/at-what-age-do-men-usually-get-benign-prostatic-hyperplasia-bph

Benign Prostatic Hyperplasia (n.d.). Retrieved August 27, 2019, from http://sua.sg/clinical-guide/patient-info/benign-prostatic-hyperplasia/

UCI Health offers non-surgical, minimally invasive procedure for enlarged prostate

Prostate artery embolization gaining popularity as a treatment for BPH

May 14, 2019

UCI Health is now offering a non-surgical treatment for men with prostate enlargement. Prostate artery embolization (PAE) is a minimally-invasive outpatient procedure to treat men with benign prostatic hyperplasia, or BPH. Since becoming available in Europe and Brazil, the procedure has rapidly gained popularity in the U.S. since FDA approval in 2017.

“The procedure works by limiting blood flow to the enlarged prostate gland, thereby reducing its size without the risks of traditional surgery,” said James Katrivesis, MD, a UCI Health interventional radiologist and assistant clinical professor in the UCI School of Medicine. “PAE is an alternative to surgery that requires no hospital stay and has little post-operative pain. Symptom improvement can be similar to surgery without the sexual or ejaculatory side effects commonly seen with surgery.”

Enlarged prostate, or BPH, is a condition common in older men. At least half of men over 60 will experience symptoms, including frequent urge to urinate, especially at night; leakage or dribbling of urine; a weak urine stream and trouble beginning urination. 

The primary traditional treatment when medications are ineffective for severe urinary symptoms related to BPH is transurethral resection of the prostate, which may be associated with side effects. PAE is known to have fewer side effects, especially sexual/ejaculatory dysfunction, and can be performed with minimal to no recovery. In addition, PAE can be performed on any size prostate and even in some patients whose prior prostate surgery has failed.

UCI Health has treated more than 50 men with PAE in the last year, since becoming one of the country’s first academic medical centers to offer the FDA-approved procedure. 

Arterial embolization has been used for decades to control blood flow and bleeding. Using X-ray guidance, an interventional radiologist inserts a small catheter into an artery and injects small particles to partially block blood flow. In the PAE procedure, the catheter is threaded to arteries that supply the prostate gland. The embolization reduces the size of the prostate and relieves symptoms of BPH. 

Men with BPH who are interested in receiving this treatment may call (714) 363-1453 or make an online appointment request at: http://www.ucihealth.org/medical-services/radiology/interventional-radiology/appointment-request

UCI Health comprises the clinical enterprise of the University of California, Irvine. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, California. The 417-bed acute care hospital provides tertiary and quaternary care, ambulatory and specialty medical clinics, and behavioral health and rehabilitation services. UCI Medical Center features Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook and Twitter.

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