Who Is A Candidate For Prostate Artery Embolization?

Non-cancerous enlargement of the walnut-shaped prostate gland can make life difficult and miserable for millions of men. The condition known as benign prostatic hyperplasia (BPH) is common in older men and can severely impact their quality of life. 

When the prostate enlarges, it puts pressure on the bladder. This restricts the flow of urine from the bladder to the urethra, the tube that passes urine out of the body. Consequently, men with BPH have to get up frequently to urinate and sometimes with great difficulty. Fortunately, a relatively new treatment called prostate artery embolization (PAE) is available to relieve the symptoms of an enlarged prostate and improve sufferers´ quality of life.

This minimally invasive procedure doesn´t involve surgery and is performed on an outpatient basis. The technique shrinks the prostate, starving it of blood. A catheter delivers microscopic particles to the blood vessels that feed the prostate. These particles obstruct (embolize) the blood flow to the gland, which gets smaller as a result.

You are a candidate for PAE if...

1. You have an enlarged prostate

BPH or an enlarged prostate is very common in men over the age of 50. It´s not cancer and usually isn’t a threat to health, but it can cause embarrassing urination issues. By the age of 60, around half of all men will have an enlarged prostate. This number grows to roughly 90% in men aged 85 and over.

Scientists aren´t exactly sure why the gland enlarges, but it could be something to do with the male hormone which controls prostate growth. There may also be a genetic component, as sons of men with enlarged prostates may be more likely to develop the condition.

2. You have urinary symptoms.

These include:

• A frequent need to urinate.
• Difficulty starting to urinate.
• A frequent need to urinate during the night (nocturia).
• Not being able to empty your bladder fully. This can create an environment for bacteria to thrive and lead to urinary infections.
• Leftover urine in the bladder can crystallize to form stones.
• A week urine stream – the urine passes at a much slower rate.
• You have to stop and start several times when you urinate.
• Urine dribbles out at the end.
• You have to strain when you urinate.

To qualify for the procedure, patients need to complete an International Prostate System Score (IPSS) questionnaire that measures the severity of prostate symptoms and their effect on quality of life. There are several questions about urinary symptoms, and each one allows the person to choose one of several possible answers indicating the increased severity of specific symptoms. The questions are:

• Incomplete Emptying:How often have you had the sensation of not emptying your bladder in the past month?
• Frequency:How often have you had to urinate less than every two hours in the past month?
• Intermittency:How often have you found you stopped and started again several times when you urinated in the past month?
• Urgency:How often have you found it difficult to postpone urination in the past month?
• Weak Stream:How often have you had a weak urinary stream in the past month?
• Straining:How often have you had to strain to start urination in the past month?
• Nocturia:How many times did you typically get up at night to urinate in the past month?

The answers to these questions range from 0 to 5.

The last question concerns quality of life:

If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?

The answer to this question ranges from 0 to 6.

Symptoms are considered mild with a score of 7 or less, moderate with a score of 8-19 and severe if the symptom score is 20-35.

3. You prefer to have a minimally invasive treatment 

Surgery is a common recommendation to treat an enlarged prostate, and while it has a high success rate, it´s not something that some men want to put themselves through. The recovery period is much longer than a minimally invasive treatment such as PAE, and there are numerous risks. These include urinary incontinence, sexual dysfunction, urination problems and bleeding.

4. You are experiencing side effects from your prostate medication

To relieve BPH symptoms, many men turn to pharmaceuticals without realizing their side effects which can last for several months or even years.

Side effects of Propecia and Proscar include:

• Low libido
• Erectile dysfunction
• Reduced sexual arousal
• Testicular pain
• Abnormal ejaculation

Side effects of Jalyn include:

• A loss of libido
• Reduced sperm count
• Ejaculation problems
• Painful erections

Side effects of Flomax include:

• Erectile dysfunction
• Orgasm problems
• Painful erections
• Retrograde ejaculations

Side effects of Avodart include:

• Testicular pain or swelling
• Loss of libido
• Reduced sperm count
• Erectile dysfunction

5. You are not a candidate for surgical options to reduce an enlarged prostate

Surgical options include:

• Transurethral Resection of the Prostate (TURP)
• Transurethral Incision of the Prostate (TUIP)
• Transurethral Vaporization of the Prostate (TVP)

If you are not a candidate for these surgical procedures, PAE might be the best option for you.

MINT Can Help You

If you have been diagnosed with benign prostatic hyperplasia and are a candidate for PAE, get in touch with us at the Midwest Institute for Non-surgical Therapy (MINT). We specialize in performing prostate artery embolization on an outpatient basis.

Contact us today for more information and to schedule a consultation at one of our 5 clinics, including the latest addition in Chicago, IL.