Physicians at UC San Diego Health are now offering prostate artery embolization (PAE) as a new treatment option for men with benign prostatic hyperplasia (BPH), or an enlarged prostate. The minimally invasive procedure is an alternative to surgery, with no hospital stay, little 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.
Picel and team have treated almost 20 patients with the new procedure.
"We have seen excellent results with the patients we have treated so far," said Alexander Norbash, chair of Radiology at UC San Diego School of Medicine. "The benefits of PAE allow patients to recover at home and return more quickly to normal activities. Symptoms may start to improve as early as the first week after treatment."
Several surgery options are also 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. 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 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 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 still ongoing and available to men who meet criteria clinicaltrials.ucbraid.org/trial/NCT03055624
For more information on PAE, visit health.ucsd.edu/specialties/radiology/ir/Pages/prostate-artery-embolization
Gabrielle Johnston, MPH