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Find out why this promising new Non-Invasive Technique has the potential of benefiting men across the Globe with Enlarged Prostates

October 10, 2017

Find out why this promising new Non-Invasive Technique has the potential of benefiting men across the Globe with Enlarged Prostates

Find out why this promising new Non-Invasive Technique has the potential of benefiting men across the Globe with Enlarged Prostates

 

     A minimally invasive treatment that reduces urinary tract symptoms for men with enlarged prostates maintains its effectiveness for at least three years after patients undergo the therapy, according to research that was presented at the Society of Interventional Radiology's 2017 Annual Scientific Meeting earlier this year. This study of 1,000 men is the largest of its kind to evaluate the long-term effectiveness of a fairly new non-invasive procedure named Prostate Artery Embolization (PAE).

WHO WILL THIS BENEFIT

    An enlarged prostate presses on the bladder, while also blocking the urethra. This means sufferers need to make repeated night-time trips to the toilet, often to find they cannot urinate at all. Also, other bothersome symptoms or this pressure on the bladder may lead to dribbling, urgency and leaking. This can lead to a build-up of toxins that cause severe kidney problems.

 

What are the most common symptoms of an enlarged prostate?

  • Frequent urination at night
  • Frequent urination that often produces only a small amount of urine
  • Hesitant or interrupted urine stream
  • Leaking or dribbling urine
  • Sudden and urgent need to urinate
  • Weak urine stream
  • Feeling like the bladder is not completely empty after urinating
  • Occasional pain when urinating
  • Having to rush to the bathroom suddenly after the urge to urinate
  • Sometimes complete obstruction when severe

 

BREAKTHROUGH PROSTATE NEWS

     There is a lot of excitement in the air surrounding this prostate treatment announced earlier this year, a brand new technique that tens of thousands of men could benefit from.

     The breakthrough treatment uses tiny plastic beads to block the blood supply and shrink the enlarged gland. The best part is that it is all done without an operation.

     A successful trial in Portugal is being followed up in Britain, with results of this clinical trial due back later this year. If successful it could be rolled out for routine use in the NHS (National Health Services) health care service organization in England.

     Half of all men over 50 suffer from an enlarged prostate and every year 45,000 men in the U.K. have risky surgery to remove part of it. Nobody likes going under the knife especially when it comes with dangerous odds and varying results.

     Not only can these operations be painful and invasive but they can lead to other harmful issues such as loss of sexual function and even incontinence. Just imagine if surgery that your doctor recommends to improve urine flow ends up having the opposite effect such that you can’t even control your bladder. +3

The bead technique has been tested on 1,000 middle-aged men in Portugal. Dr. Joao Martins Pisco, who led the study at St. Louis Hospital in Lisbon, Portugal said: ”Within five years I think this will replace surgery as the standard treatment”.

The technique uses tiny plastic beads to block the blood supply and shrink the enlarged gland – and the best part is that it is done without operating 

   

Promising Outlook

 

     Prostate artery embolization gives men a treatment option that is less invasive than other therapies and surgeries and allows them to return to their normal lives sooner. 

     The team stated that patients are relieved to find out about prostate artery embolization because they are not able to tolerate prescription medications due to their side effects.

     “These men also don't want traditional surgery because it involves greater risks, has possible sexual side effects, and has a recovery time that is relatively long compared to prostate artery embolization, which is generally performed under local anaesthesia and on an outpatient basis.” This means this procedure can have a patient not having to be admitted into a hospital for days on end for pre-surgery and post-surgery protocols.

     The Portuguese team presented its findings at the Society of Interventional Radiology in Washington DC earlier this year and concluded that the procedure is as effective as surgery and the benefits may last just as long. Only two patients in the seven-year trial had clinical side effects.

     Dr. Pisco also added: “I have had nine babies born to men who were able to continue their sex lives after having the treatment.” 

     His team saw an 89 per cent success rate six months after surgery, 82 per cent success up to three years, and 78 per cent beyond three years.

     Two hundred patients in Southampton General, Guy's Hospital in London and 16 other clinics are involved in a trial in the UK.

Half of all men over 50 suffer from an enlarged prostate in the U.K. and every year 45,000 have risky surgery to remove part of it

     Dr. Nigel Hacking, who is leading the study, said: “It is very encouraging. I am always cautious about new techniques but this procedure seems to be showing promise and it seems to be safe.”

     Louise de Winter of the Urology Foundation said: “This research is very exciting. As the population ages these problems are going to get even more acute.”

     An estimated 45,000 men undergo surgery for enlarged prostates every year in the UK.

 

YOU’RE PROBABLY WONDERING HOW IT WORKS?

     Performed under local anaesthetic, the procedure involves injecting hundreds of 0.2mm plastic beads into an artery located in the groin. 

     The beads are directed with a thin tube into the blood vessels that flow to the prostate, blocking blood supply to the enlarged gland. During the procedure, a small, spaghetti-like catheter is placed via an artery in the right groin into the arteries that supply the prostate. Very small particles are injected into the prostate arteries to decrease blood supply to the prostate, thus reducing its size and symptoms.  The procedure severely restricts blood flow to the tissue, but there is still a little bit of blood flow through collateral vessels that keeps the tissue alive while it shrinks over time. With the blood flow reduced, the prostate will shrink in size, thereby relieving the symptoms of BPH.

 

COMMONLY ASKED QUESTIONS

Will I need to stay overnight in the hospital?

Most often patients are discharged from the hospital three hours after the procedure, but sometimes it may be necessary to stay overnight.

Will I need a foley catheter or catheter inserted via the penis?

It is routine practice to not place a catheter via the penis.

Do I need to have general anesthesia for the procedure?

Patients are given a sedative medication for the procedure, similar to that given for a colonoscopy which is often referred to as "twilight sleep”. There is no need for general anesthesia. The procedure is not considered painful and some patients elect to have no sedation.

What are the results from the procedure so far?

Results are very promising with greater than 90 percent of patients seeing extreme improvement. Approximately 7 percent of patients see moderate improvement and 1 to 2 percent may see no improvement.

Can the procedure be repeated if my symptoms return?

Yes, this technique is able to re-done if the symptoms are continuously bothersome and hasn’t improved from the initial procedure.

What are the results of prostate artery embolisation?

The results of two medium term studies of the results of prostate artery embolization showed over 70% of men will gain symptomatic improvement after PAE with reduction in prostate volumes and an increase in urinary flow rates. Difficulty in finding difficult or small prostate arteries may lead to technical failures in around 10% of cases. In case of failure traditional TURP surgery may be offered.

Some of your questions should have been answered by this information, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Do satisfy yourself that you have received enough information about the procedure, before you sign the consent form.

PAE is probably a safe procedure, designed to improve your medical condition and save you having a larger operation. There are some risks and complications involved, and you do need to make certain that you have discussed all the options available with your doctors.

 

 

Traditional Prostate Surgery VS Prostate Artery Embolization

 

Transurethral Resection of the Prostate (TURP)

 

     Transurethral resection of the prostate (TURP) is the gold standard to which other surgeries for BPH are compared. This procedure is performed under general or regional anesthesia and takes less than 90 minutes.

     The surgeon inserts an instrument called a resectoscope into the penis through the urethra. The resectoscope is about 12 inches long and 3/8 of an inch in diameter. It contains a light, valves for controlling irrigating fluid, and an electrical loop to remove the obstructing tissue and seal blood vessels. The surgeon removes the obstructing tissue and the irrigating fluids carry the tissue to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time.

     Patients usually stay in the hospital for about 3 days, during which time a catheter is used to drain urine. Most men are able to return to work within a month. During the recovery period, patients are advised to:

 

  • avoid heavy lifting, driving, or operating machinery
  • drink plenty of water to flush the bladder
  • eat a balanced diet
  • use a laxative if necessary to prevent constipation and straining during bowel movements

 

Possible complications of TURP

Side effects of this surgery may include:

  • bleeding during the surgery, which requires a transfusion
  • improper fluid absorption
  • salt imbalances caused by fluid absorption issues
  • impotence (erectile dysfunction)
  • incontinence
  • urethral stricture (narrowing) leading to a “split stream” of urine
  • post-TURP syndrome

 

     Post-TURP syndrome is a rare but serious condition that occurs when too much fluid is absorbed during the TURP procedures. The initial symptoms include dizziness, headache, and a slow heart rate. Symptoms can progress to include shortness of breath, seizures, and coma.  

     Blood in the urine is common after TURP surgery and usually resolves by the time the patient is discharged. Bleeding also may result from straining or activity.    

     Some patients have initial discomfort, a sense of urgency to urinate, or short-term difficulty controlling urination. These conditions slowly improve as recovery progresses, but it is important to remember that the longer the urinary problems existed before surgery, the longer it takes to regain full and normal bladder function after surgery.      

     Up to 30 percent of men who undergo TURP experience problems with sexual function. Complete recovery of sexual function may take up to 1 year. The most common, long-term side effect of prostate surgery is retrograde ejaculation (dry climax), which results when the muscle that closes the bladder neck during ejaculation is removed along with the obstructing prostate tissue. Semen enters the wider opening to the bladder instead of being expelled through the penis, causing sterility but not affecting the man's ability to experience sexual pleasure. This complication is not an issue for most men requiring prostate surgery.

     As compared to the gold standard surgery TURP, Prostate Artery Embolization (PAE) seems to be a new alternative for those men that are candidates and that cannot tolerate their prescription medications. It is still a bit early to conclude that PAE is going to replace this standard, but the results of the completed studies and the anticipation of the results of current studies show promising results. It is up to you and your physician to discuss options and determine if this is the correct course of action you should take.

 

IS THIS RIGHT FOR YOU?

 

     If you suffer from Lower Urinary Tract Symptoms (LUTS), or from an enlarged prostate or BPH, Prostate Arterial Embolization may be useful, but the “verdict” is out. Maintaining an ideal weight, exercise and a good natural supplement can help to alleviate mild to moderate LUTS and support prostate health. Prostate Arterial Embolization (PAE) is not FDA approved in the United States, but it is offered in numerous places for an out-of-pocket expense.         

    Tampa General is now one of the first hospitals in the United States offering a minimally invasive procedure to treat an enlarged prostate. The University Of North Carolina Center for Heart and Vascular Care, Inova Alexandria Hospital in Virginia, and RIA Endovascular in Colorado have also been preforming this procedure in the USA.