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Condition

Benign Prostate Hyperplasia (Enlargement)

When sufficiently large, the nodules compress the urethral canal. This can cause partial, or sometimes virtually complete, obstruction of the urethra.

What is Benign Prostate Hyperplasia?

Benign Prostate Hyperplasia (BPH) is a condition more commonly known as enlarged prostate gland. An enlarged prostate gland can cause compression of the urethra. This can cause partial, or sometimes complete, obstruction. An enlarged prostate can interfere with the normal flow of urine and cause discomfort and inconvenience.

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What are the symptoms of BPH?

Benign Prostate Hyperplasia (BPH) is a condition more commonly known as enlarged prostate gland. An enlarged prostate gland can cause compression of the urethra. This can cause partial, or sometimes complete, obstruction. An enlarged prostate can interfere with the normal flow of urine and cause discomfort and inconvenience.

  • Frequent or urgent need to urinate

  • Increased frequency of urination at night (nocturia)

  • Difficulty starting and maintaining urination (hesitancy or straining)

  • Weak urine stream or a stream that starts and stops

  • Dribbling at the end of urination

  • Inability to completely empty the bladder

What imaging/tests are done to diagnose Benign Prostate Hyperplasia?

The only lab test that is universally recommended for BPH is urinalysis. Serum prostate-specific antigen (PSA) levels are used as a marker for prostatic diseases, including BPH. An ultrasound can help confirm prostate size. BPH is diagnosed based on a written clinical history, digital rectal exam findings, and focused urologic examination findings.

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What intervention/treatment can be performed for Benign Prostate Hyperplasia?

There are several options for patients who suffer with BPH. When considering a possible treatment plan, your physician and you will want to consider your symptoms, the severity of the symptoms, lifestyle considerations and your own preferences.

Options to treat BPH include:

  • Watchful waiting

  • Medications

  • Prostate surgery – There are a variety of surgical options.

  • Prostate artery embolization – This is a minimally invasive, non-surgical procedure offered at UroCare /CardioCare.

BPE
 

Treatment

Prostate Artery Embolization (PAE)

A revolutionary treatment recently approved by the FDA and recommended by CIRCE to provide relief from Benign Prostate Hyperplasia (BPH).

What is Prostate Artery Embolization?

Prostate artery embolization is a minimally invasive, nonsurgical procedure used to treat benign prostate hyperplasia. It is performed by an interventional radiologist, on an outpatient basis. In this procedure, the interventional radiologist will thread a tiny catheter through the artery in the groin to the arteries supplying blood to the prostate gland. Tiny beads will then be injected to embolize, or cut off the blood flow to, the prostate gland. The decreased blood flow causes the prostate gland to shrink, which helps to decrease the overall size of the prostate gland and relieve the symptoms of BPH.

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Why would you need Prostate Artery Embolization?

This minimally invasive procedure is an option for patients suffering from benign prostate hyperplasia. BPH is a noncancerous enlargement of the prostate gland and is the most common benign tumor found in men. 

Risks involved

Our ability to use imaging guidance and cutting-edge technology minimizes patient risk. Prior to your procedure, your physician will discuss any potential risks with you.

 

Because this minimally invasive procedure is not touching the prostate or any of its adjacent tissues, the patient will not see negative side effects like incontinence or impotence. In some cases there may be some blood in the urine or semen. All of these will either resolve on their own, or can be treated with a short course of medication. Further possible complications will be discussed with your personally in detail.

 

As there is no pathway from the prostate to the lungs or brain, it is impossible for the particles to cause blood clots in the lungs, leading to a possible stroke. The particles all become lodged in the prostate. The particles do not dissolve and are permanent. Interventional radiologists have been using the same particles for other procedures for many years and have not seen any problems arise from them.

 

Other small risks of the procedure include blood in the urine; leakage of blood in the puncture site; bladder spasm; or infection of the puncture site or prostate. All of these potential complications will either resolve on their own, or can be treated with a short course of medication.

Conditions to let us know about

Let your doctor know if you are feeling ill, have a fever, or are taking any blood thinners.

Insurance coverage

Prostate artery embolization (PAE) is covered by most private insurance providers. We will seek authorization from your insurance company prior to your procedure.

Interventional Radiology. Prostatic arte

Preparing for your procedure

If you are on blood thinners your doctor will instruct you if you need to stop these medications prior to the procedure. If your procedure requires sedation, then you will need a responsible adult to give you a ride home.

During the PAE procedure

General anesthesia is not used for the PAE procedure, so the patient will not be “put to sleep”. The patient will receive IV medications that take away pain and anxiety with the goal of making them comfortable for the entire procedure. The procedure itself is not painful. The most discomfort that patients report is from lying flat on their backs for the duration of the procedure.

 

The PAE procedure can be challenging because of the very small size of the prostatic arteries and the ‘twists-and-turns’ that need to be navigated with the catheter to get to them. At UroCare we are equipped with the Siemens advanced Syngo Embolization Software and the dynoCT/Cone Beam CT. This allows us more precise and accurate navigation inside the vessels and enables us to obtain CT images on the procedure table and simulate the injection of the embolization particles before the actual injection takes place, increasing the accuracy and safety of the intervention.

 

We use the embolization particles by Merit medical, the most experienced provider on the market. These embolization beads will not dissolve and do not need to be removed. They also cannot dislocate and damage any other parts of your body.

Recovering from your procedure

You may possibly receive mild to moderate sedation during your procedure. If access through the wrist artery was possible, you will stay in the recovery area until you are ready for discharge approx. 5 hours later. In case of access through the groin artery, you will be monitored overnight for signs of bleeding from the needle insertion site.

 

In both cases you will be given written post procedure discharge instructions that will advise you about return to normal physical activity.

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After the PAE procedure

There is no special care required after the procedure. You will be discharged the same day if access was achieved through the wrist artery or the next day after groin arterial access. In case that your site of access via needle puncture was chosen to be the groin, you may need to rest groin mobility for a week after the procedure, avoiding heavy lifting and bending of your hip.

 

If you have any questions after your procedure, please call CardioCare on (+34) 677 759 003.

 

Because the PAE procedure does not involve surgery or physical removal of part of the prostate, the results will not be noticed immediately. Over a six- month period, the prostate will shrink by 20-40%, resulting in improved and less frequent urination. The first changes are seen most commonly 1-2 months after the procedure with continued improvement until 5-6 months afterward.

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