Men With BPH Have Options

If you are a man over the age of 50, chances are high (more than 50%) that you may experience an enlarged prostate one day.

This condition, called Benign Prostatic Hyperplasia (BPH), can cause you to have pain or trouble urinating, urinary tract infections and even bleeding. When you have BPH, the prostate gland gets bigger and may compress the urethra (the tube that carries urine from the bladder and then out of the body). As this happens, the bladder wall thickens and becomes irritated, and begins to contract even when it contains small amounts of urine.

Treatments depend on the individual. But a new procedure called Prostate Artery Embolization (PAE) may offer a better, safer and easier approach for many men.

What is PAE?

In a PAE procedure, a doctor makes a small incision in your upper thigh, says Dr. Shivank Bhatia, an interventional radiologist who is helping to perfect the new procedure. Then, using an X-ray, the team guides the catheter into the artery that supplies blood to the prostate (located between the bladder and penis). The doctor then injects tiny beads to temporarily block the blood flow to the prostate gland.

“This process is repeated on the other side of the prostate,” says Dr. Bhatia of the University of Miami Health System. “The prostate gland then shrinks in size and symptoms are relieved. Blood is not providing as many nutrients to help it grow.”

What are the benefits of PAE?

Pioneering a less invasive, less costly approach

Dr. Bhatia and his team have done multiple research studies that have shown the statistical benefits of this less invasive option for some men.

“When medical therapy (prescriptions) are not appropriate, several other surgical approaches are available, including transurethral resection of the prostate (TURP) for some patients,” he says. “TURP surgery, however, can be associated with a higher risk of bleeding, urine leakage, and sexual side effects.”

His latest analysis of PAE studies was published in the June 2019 issue of Radiology Today. The data showed a lower incidence of bleeding, less incidence of urinary tract infection, greater quality of life and fewer reports of treatment-associated sexual dysfunction or urinary incontinence than TURP.

So far, more than 550 patients have selected this treatment at UHealth. The majority of the patients treated with PAE go home a few hours after the procedure, he says. The average recovery time is five to seven days.

“This condition is so common, and can be a huge cost to the healthcare system,” says Dr. Bhatia. “Many other minimally invasive options are being studied. But our work has proven that PAE is becoming an outpatient procedure well-suited for men with larger prostate growth. It is also an excellent choice for patients for whom medical therapy is not an option, and for the elderly, if conventional surgery presents too many risks.”

The multidisciplinary team has trained more than 400 other doctors from all over the world in the procedure.

What are the symptoms of BPH?

BPH can lead to problems associated with lower urinary tract symptoms that may include:

• An urgent need to urinate
• Increased frequency of urination—especially at night (nocturia)
• Inability to urinate or straining while urinating
• Weak urine stream
• A urine stream that starts and stops (intermittence)
• Inability to empty your bladder completely
• Urinary tract infections (UTIs)
• Dribbling at the end of urinating

Left untreated, BPH could lead to health complications such as kidney stones, infection, lack of bladder control (called neurogenic bladder), or complete bladder outlet obstruction.

Call 305-689-2636 to schedule an appointment.

John Senall is a contributing writer for UMiami Health News. He is a former hospital and comprehensive cancer center communications director.

Tags: BPH, Dr. Shivank Bhatia, PAE