Alleviating a Stream of Problems for Older Men with Prostate Woes

 

By Gabrielle Johnston, MPH   |   August 29, 2018

​Having to frequently urinate or difficulty in urinating are among the frustrations that some men face with age. These are often symptoms of an enlarged prostate and something that, for the past few decades, men simply lived with. If symptoms become too severe, a trip to the doctor might be needed and, perhaps, surgery.

There’s now a new option. 

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For the first time, UC San Diego Health physicians are offering prostate artery embolization (PAE) as a new treatment alternative for men with benign prostatic hyperplasia (BPH) or, more simply, an enlarged prostate. The minimally invasive procedure is an alternative to surgery, requiring no hospital stay, little post-operative pain and lower cost.

“PAE has been available in Europe as a treatment option for an enlarged prostate for several years,” said Andrew Picel, MD, interventional radiologist at UC San Diego Health. “With the recent FDA approval of this procedure, we are happy to offer this as an alternative to surgery for patients who are good candidates.”

Using X-ray guidance, interventional radiologists insert a small catheter into an artery in the upper thigh or wrist. The catheter is then threaded into the arteries supplying the prostate. Small particles are injected to partially block the blood flow to the prostate. This reduces the size of the prostate and relieves symptoms of BPH. 

“PAE allows our patients to be able to recover in the comfort of their own homes,” said Jeet Minocha, MD, chief of vascular and interventional radiology at UC San Diego Health. “Within one month, most patients typically see an improvement in symptoms, which permits them to return to the normal activities they enjoy.”

One of the approximately 20 patients Picel and team already have treated with the new procedure reported, “I can now leave the house without worrying about bathroom stops. This procedure has changed my life considerably for the better.”

Several surgical options are available, including transurethral resection of the prostate (TURP), which is considered the gold standard for treatment of BPH. However, TURP requires full anesthesia, an overnight hospital stay, three to six weeks of recovery time and is associated with sexual side effects.

Enlarged prostates affect at least half of men over 60 years of age. Possible symptoms include a frequent urge to urinate, especially at night; leakage or dribbling of urine; a weak urine stream and trouble beginning urination. BPH can cause other problems if untreated, such as kidney, bladder and urinary tract infections.

UC San Diego Health interventional radiologists and urologists screen patients as potential candidates for PAE. Typically, candidates are 50 to 85 years of age, have urinary tract symptoms, have unsuccessfully tried medications within the last six months and have undergone assessment for prostate cancer risk. It is important that patients understand the full range of available treatment options to make an informed decision and pursue the treatment best suited for their individual medical situation.

“It is great that patients now have a minimally invasive alternative to surgery to help with this common health problem,” said Picel. “The collaboration between interventional radiology and urology is why we are seeing such success in treating patients with PAE.”

In March of 2017, UC San Diego Health launched a clinical trial on PAE, making it one of the first medical centers in California to offer PAE. The clinical trial at UC San Diego Health is ongoing and available to men who meet criteria.

For more information on PAE, visit health.ucsd.edu/specialties/radiology/ir/Pages/prostate-artery-embolization


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