Prostatic Artery Embolization

Nocturia refers to an uncontrollable and severe urge to urinate during night hours. It is a fairly common urological complaint among men with large or over-sized prostate gland. Nocturia can affect a man’s day-to-day activities and productivity due to:

• An inability to get a good amount of sleep due to frequent awakenings at night time.
• A repeated urge to urinate regardless of the amount of water intake.
• An increased risk of embarrassing urological accidents (such as urinary leakage).
• A higher risk of developing urinary tract infections as well as other complications such as herniation.

How To Address Prostatic Enlargement?

Prostatic enlargement is a serious issue that affects about 50% men between 50 to 60 years of age. The prevalence of prostatic enlargement increases with advancing age and according to latest estimates, more than 90% males over 80 years of age have recognized prostatic hypertrophy.

Although there are several treatment options available that can address the symptoms of prostatic enlargement; but efficacy and long term benefits of most current solutions is questionable. For long researchers and scientists have been working on different treatment modalities to manage prostatic enlargement and just recently, a new treatment approach has been unveiled.

What Is Prostatic Artery Embolization (PAE)?

The bothersome symptoms of prostatic hypertrophy can be managed with a new and revolutionary treatment strategy, known as prostatic artery embolization (PAE). This method involves blockage of the artery that is responsible for supplying the blood towards your prostate gland. The blocking is done via spheres that are microscopic in size and have the ability to partially block the blood flow due to which the prostate gets soft and shrunk as a result of ischemia or low oxygen delivery). As a consequence, the severity of urinary complaints is also reduced significantly.

Details Of Prostatic Artery Embolization Procedure

This procedure is performed by placing a catheter inside the femoral artery which is then directed towards the pair of prostate arteries. Then a beaded microscopic biological substance is inserted into the arteries which blocks the blood flow.

In order to check the effectiveness of this method, a research study was conducted on 68 men, out of which 46 males reported after one month of the procedure that they all had felt noticeable relief in the intensity and severity of symptoms.

At 3-month follow-up, 38 men received PAE out of which 28 reported a marked reduction in the frequency of urination episodes per night. Researchers also believe that more than the size reduction, it is the softening of the gland which helps in relieving the symptoms. Another logical reason can be less active prostate which reduces the stimulation towards sympathetic nervous system that triggers the message for urination.

Are There Any Side-Effects Of Prostatic Artery Embolization Procedure?

It is a safe procedure with mild to moderate post-surgical discomfort. The only possible side effects are bleeding and infection which are reported in less than 1% men undergoing this procedure. Since it is an invasive method and the positive effects generally lasts for 36 months to 48 months at maximum, due to which few healthcare professionals think that this method is unnecessary.

In other words, there are already pills in the market that can treat enlarged prostate, which are quite effective with minimum side effects. However, in the United States there are about 25-30 medical centers which are performing PAE as part of the clinical trial and regular treatment as well. PAE is not covered under health insurance policies but in the University of North Carolina’s Center for Heart and Vascular Care, the patients who enroll in clinical trials for PAE are covered by Medicare.

Speak to your doctor if you are a candidate for Prostatic Artery Embolization Procedure.

References

• Bagla, S., Martin, C. P., van Breda, A., Sheridan, M. J., Sterling, K. M., Papadouris, D., ... & van Breda, A. (2014). Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia. Journal of Vascular and Interventional Radiology, 25(1), 47-52.
• Antunes, A. A., Carnevale, F. C., da Motta Leal Filho, J. M., Yoshinaga, E. M., Cerri, L. M., Baroni, R. H., ... & Srougi, M. (2013). Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovascular and interventional radiology, 36(4), 978-986.
• Carnevale, F. C., da Motta-Leal-Filho, J. M., Antunes, A. A., Baroni, R. H., Marcelino, A. S., Cerri, L. M., ... & Srougi, M. (2013). Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. Journal of Vascular and Interventional Radiology, 24(4), 535-542.