New Treatment for Enlarged Prostate

A new treatment could provide men with relief from symptoms of an enlarged prostate with fewer side effects than traditional methods.

The minimally invasive technique isn’t entirely new, but a study presented this week at the Society of Interventional Radiology's Annual Scientific Meeting shows that the method could be an alternative to commonly used treatments for benign prostatic hyperplasia (BPH).

“This innovative treatment offers less risk, less pain and less recovery time than traditional surgery,” said Dr. Sandeep Bagla, the study's lead researcher and an interventional radiologist at Inova Alexandria Hospital in Virginia, in a press release. “We are hopeful that further research will confirm it to be an effective therapy for BPH.”

BPH affects about one-third of men 50 years or older, and 90 percent of men 85 years or older. According to Medscape, up to 14 million men in the United States experience symptoms due to an enlarged prostate.

doctor and patient

Researchers looked at the medical records of 78 men who were treated for an enlarged prostate using the new technique — prostate artery embolization. Doctors performed the procedure as part of their routine clinical practice, not through a clinical study.

The procedure worked in 96 percent of the cases. The blood vessels were also successfully blocked, regardless of the size of the enlarged prostate before the procedure. Stopping the flow of blood to the prostate causes it to shrink, which can relieve symptoms.

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Reduced Symptoms and Better Quality of Life

Men who had the procedure done experienced an improvement in their quality of life and a drop in their symptoms. This was true at one, three, and six months after the procedure.

Men also reported no change in their sexual function, a side effect that may occur with other surgical treatments for enlarged prostate. Two men, however, experienced minor problems after the procedure, including bruising in the groin and a urinary tract infection.

An enlarged prostate can compress the urethra — the tube that carries urine from the bladder — where it passes through the gland. This can cause symptoms such as frequent or urgent urination, or the inability to completely empty the bladder.

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Technically Challenging Procedure Offers New Option

Doctors perform prostate artery embolization by inserting a catheter into the femoral artery in the thigh. They direct this tube to the prostate artery on both sides of the enlarged gland.

The doctors then inject a fluid containing thousands of tiny particles into the catheter. These block the small blood vessels of the prostate and starve it of its blood supply.

The procedure itself is technically challenging. As a result, it’s carried out by interventional radiologists, who have experience using small catheters and other techniques for blocking arteries.

According to the researchers, accessing the prostate through the femoral artery may be the reason for the low number of side effects.

Other treatments for an enlarged prostate — such as transurethral resection of the prostate (TURP) — require doctors to insert tools through either the urethra or penis.

Also, currently used techniques may not be available to all men.

“Many men have benign prostatic hyperplasia that cannot be treated by traditional methods,” said Bagla, “such as when the BPH is smaller than 50 cubic centimeters or larger than 80 cubic centimeters.”

“Prostate artery embolization offers these patients an effective treatment that results in reduced risk of bleeding, urinary incontinence or impotence, compared to other BPH therapies, offering patients a better quality of life,” he added.

Earlier studies of prostatic artery embolization included two presented at the Society of Interventional Radiology's Annual Scientific Meeting in 2012 and one study in 2014. All three of those studies showed that the technique was effective with few side effects.

Even with the current study, however, more research is needed. Scientists need to follow patients longer to see if the benefits last beyond one year.

Plus, randomized clinical trials will be needed to compare the safety and effectiveness of the new method with other treatment options.

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