Benign Prostatic Hyperplasia & Men’s Health
What is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH) is a benign (non-cancerous) condition that develops when the prostate and the surrounding gland enlarges. As the gland grows, it can squeeze the urethra, the tube in the penis connected to the bladder, blocking the flow of urine. The bladder becomes thicker as it works to overcome this obstruction but over time it may weaken and lose the ability to urinate normally.
Who is at risk for Benign Prostatic Hyperplasia (Enlarged Prostate)?
- Nearly all men will develop BPH as they age.
- By 60, 50% of men will have some signs of BPH.
- This increases to 90% of men by age 85.
What does the research say about Benign Prostatic Hyperplasia (Enlarged Prostate)?
- Prostate artery embolization (PAE) is an effective treatment for symptoms of BPH
- PAE has been demonstrated to be as effective as TURP in improving symptoms and quality of life in some studies
- Most studies show a much lower procedural risk with PAE compared to surgical alternative
I’ve been told I need surgery (or surgery plus another procedure) to treat BPH. Is this true?
No, a single, minimally invasive outpatient procedure is all you need to treat this condition. Prostate artery embolization (PAE) is an excellent alternative to surgery and other outpatient procedures. Under no circumstances should multiple procedures (including surgery) be required to treat an enlarged prostate.
Read more about our non-surgical solution »
Benign Prostatic Hyperplasia (BPH) Symptoms
The symptoms of BPH are known as lower urinary tract symptoms (LUTS), these symptoms include:
- Hesitancy
- Poor and/or intermittent stream
- Straining to urinate
- Prolonged urination
- Feeling of incomplete bladder emptying and dribbling
- Frequent urination
- Feeling sudden urgency to urinate
- Urinating multiple times at night
If you are experiencing signs and symptoms of BPH, and are finding it difficult to perform your daily activities and maintain your way of life, contact your primary care physician immediately.
What are my enlarged prostate treatment options?
Non-Invasive Treatment Options
- Medication is the most common treatment for mild to moderate symptoms of BPH.
- Alpha blockers
- 5-alpha reductase inhibitors
- Tadalafil
Side-effects of these treatments include sudden drop in blood pressure, abnormal ejaculation, intraoperative floppy iris syndrome (increases risks of cataract surgery), decreased libido, breast tissue development in men and more.
Surgical Treatments
Open prostatectomy
An incision is made in the lower abdomen to reach the prostate and remove the tissue. Patients with larger prostates (>80-100 cc) require open prostatectomy rather than trans-urethral resection of the prostate (TURP). Open prostatectomy is associated with a higher risk of bleeding requiring blood transfusion, erectile dysfunction, retrograde ejaculation and incontinence. Open prostatectomy requires hospitalization following the procedure.
Transurethral resection of the prostate (TURP)
A scope and cutting instrument is inserted into the penis and the inner part of the prostate is cut and removed. This surgery is limited to prostates <80-100 cc in volume. Up to 75% of men undergoing TURP can experience retrograde ejaculation. Other risks include urinary incontinence, erectile dysfunction and urethral strictures.
Transurethral incision of the prostate (TUIP), Transurethral microwave thermotherapy (TUMT), Transurethral needle ablation (TUNA), Holmium laser enucleation of the prostate (HoLEP)
Similar procedures where a scope is inserted into the penis. The prostate gland is cut or destroyed using microwave, radio waves or laser, depending on the procedures. Risks of these procedures include retrograde ejaculation, urinary incontinence, erectile dysfunction and urethral strictures.
Prostate Artery Embolization
Prostate artery embolization is an alternative to surgery and other procedures. It is a minimally invasive procedure—performed in an outpatient setting—that is effective at shrinking the prostate gland to reduce or eliminate the symptoms of BPH. It is safer than surgery, and unlike other procedures, it treats the root cause of the problem (the enlarged prostate). Learn more »
Prostate Artery Embolization (PAE)
In prostate artery embolization (PAE) an Interventional Radiologist (IR) passes a catheter (small tube) through an artery in the wrist or the groin using specialized x-ray equipment. The catheter is guided into the blood vessels supplying the prostate. Once the catheter is appropriately positioned, embolic material (small particles) are injected through the catheter and into the blood vessels feeding the prostate, cutting off its supply of oxygenated blood. This shrinks the prostate. The embolic material remains permanently in the blood vessels in the prostate. Once embolization is complete the catheter is removed. The entire treatment typically lasts 1-2 hours and is an outpatient procedure. Recovery typically takes less than one week.
Is Prostate Artery Embolization (PAE) right for me?
You may be a candidate for PAE if:
- You are experiencing lower urinary tract symptoms of BPH
- You do not want surgery
- You do not want the potential risks of surgery
- You are a poor surgical candidate
- Key Advantages
PAE is a safe treatment option and like other minimally invasive procedures has significant advantages over conventional open surgery.
Benefits
- Multiple research studies demonstrating significantly improved urinary symptoms for most patients
- Same day procedure
- No general anesthesia required
- No risk of retrograde ejaculation
- No risk of urethral strictures
- Near zero risk of blood loss requiring transfusion
- Potential to improve sexual function
Risks
Although PAE complications are rare, any medical procedure carries some degree of risk. Despite the low risk factor, it is important to understand the potential complications associated with PAE. These include:
- Embolization of non-target organs (bowel, bladder, nerves, and buttock)
- Post-embolization syndrome (post-procedure pain, fever, tiredness, and elevated white blood cell count)
- Small amount of blood in urine, seman or stool for a short duration
- Leakage of blood at the puncture site
Take our quiz below to determine if you are a candidate for prostate artery embolization.
Prostate Artery Embolization FAQs
Varicoceles
What are varicoceles?
A varicocele is an enlargement of the veins surrounding your testicles in your scrotum. It is caused by faulty valves in veins leading to pooling of blood in the scrotal veins (pampiniform plexus). This can lead to shrinkage of the affected testicle – more commonly on the left – and lead to decreased testosterone levels. Varicoceles are a common cause of male infertility.
Who is at risk?
- 15% of all men develop varicocele
- Increased weight
What does the research say?
- Repairing varicocele improves testicular function
- Varicocele embolization has similar success rates as surgical treatments
- Varicocele embolization has lower complication rates compared to surgery
Symptoms of Varicoceles
Common symptoms associated with Varicoceles:
- None – most men with varicoceles have no symptoms.
- Dull ache in the testicles
- Lump in the testicles
- Swelling of the testicles
- Enlarged veins of the testicles (described as feeling like a “bag of worms”)
Treatment Options
- Varicocele Ligation
- Varicocele Embolization
Varicocele Embolization Treatment
In varicocele embolization an Interventional Radiologist (IR) passes a catheter (small tube) through a vein in the groin using specialized x-ray equipment. The catheter is guided into the gonadal veins. Once the catheter is appropriately positioned, the veins are blocked off using metallic coils and sclerosing agents. The entire treatment typically lasts less than 1 hour and is an outpatient procedure. Recovery typically takes 24-48 hours.
Is varicocele embolization right for me?
You may be a candidate if:
- You have pain in your testicle
- You have infertility
- You feel dilated veins in your testicle
- Have low testosterone levels
- Do not want surgery
Key Advantages
Varicocele embolization is a safe treatment option and like other minimally invasive procedures has significant advantages over conventional open surgery.
Benefits
-
- High treatment success rates
- Same day procedure
- No general anesthesia required
- Lower risk compared to surgery
Potential Risks
Although varicocele embolization complications are rare, any medical procedure carries some degree of risk. Despite the low risk factor, it is important to understand the potential complications associated with varicocele embolization. These include:
-
- Infection
- Other Treatment Options
- Surgical Treatments
- Varicocele ligation
