As men age, their prostate — the gland that produces semen — continues to grow. For men whose prostates remain an average size, like a walnut or a golf ball, this presents no problem. But some men have excessive prostate growth, where the gland can get to be the size of an orange. This places pressure on the urethra and bladder, which can cause problems with urination.
This condition is called benign prostatic hyperplasia, or BPH. It is not a type of prostate cancer, nor does it cause it. BPH is incredibly common — about half of men over 50 have it, and around 90% of men over 80 have the condition. While some men may never need treatment for their BPH, other men may find their symptoms worsening.
The good news is that there are several treatment options for BPH, including an outpatient procedure called prostatic artery embolization, or PAE. The expert interventional radiologists at Vascular & Interventional Specialists offer this minimally invasive, long-lasting relief from the symptoms of an enlarged prostate.
Risk Factors for BPH
Research has not yet determined the exact cause of BPH, but hormonal changes are likely involved. Common risk factors include:
- Being age 40 or older
- Being overweight
- Having a family history of BPH
- Having cardiovascular issues
- Having Type 2 diabetes
- Lack of regular exercise
While there is no certain way to prevent BPH, losing weight and exercising several times a week may help lower your risk. Excess body fat can affect hormone levels in your body, which may in turn affect how your prostate cells grow.
How BPH Is Diagnosed
You might think urinary dysfunction is just a normal part of aging. But if you have BPH, it doesn’t have to be. Also, some symptoms of BPH are similar to other more serious conditions. It’s time to talk to a doctor if you are experiencing symptoms like:
- Blood in your urine
- Dribbling after urination
- Feeling like you still need to urinate after going
- Frequent or urgent need to urinate
- Frequent UTIs
- Increased nighttime urination
- Trouble starting or stopping urination
- Weak urine stream
If BPH progresses, it can become increasingly painful for men. It can also cause bladder, kidney, and urinary tract problems.
If your provider suspects BPH may be causing your urinary issues, diagnostic imaging can be used to confirm the condition and the size of the prostate and determine if you’re a good candidate for PAE. Blood tests may also be done to evaluate if it’s prostate cancer. Types of imaging that may be done include:
- CT scan
Treatment for BPH
If your physician recommends treatment for BPH, you may have several options, depending on the size of the prostate growth. Some men with BPH may find symptoms improve with weight loss, muscle strengthening, and medication.
If medication does not improve your BPH, your provider may suggest a minimally invasive procedure. Many men also experience erectile dysfunction as a side effect of certain medications, and they may want to discuss other options to avoid it.
With a clinical success rate of over 80%, prostatic artery embolization (PAE) has become increasingly popular as a treatment option for BPH. PAE has minimal complications and shorter recovery times than other procedures, and it does not worsen erectile function or cause incontinence, which can happen after certain surgical procedures.
During a PAE procedure, an interventional radiologist will use advanced imaging to guide a tiny catheter up the blood vessels in your arm, down through your body to your prostate. They then place small beads in blood vessels on either side of your prostate to limit blood flow to it. This causes the prostate to shrink, often relieving symptoms within days. This fast and effective treatment is completed in a matter of hours, and you can go home the same day.
While not every man with BPH is a candidate for PAE, the procedure has less than a 0.5% chance of a major complication and has minimal side effects, making it an ideal choice for many.
If you’re experiencing symptoms that could be signs of an enlarged prostate or BPH, request a consultation with the interventional radiologists of Vascular & Interventional Specialists to learn more and see if you could be a good candidate for prostatic artery embolization.
- 3. McWilliams JP, Bilhim TA, Carnevale FC, Bhatia S, Isaacson AJ, Bagla S, Sapoval MR, Golzarian J, Salem R, McClure TD, Kava BR, Spies JB, Sabharwal T,
McCafferty I, Tam AL. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment
of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and
Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology: Endorsed by the Asia
Pacific Society of Cardiovascular and Interventional Radiology, Canadian Association for Interventional Radiology, Chinese College of Interventionalists,
Interventional Radiology Society of Australasia, Japanese Society of Interventional Radiology, and Korean Society of Interventional Radiology. J Vasc Interv
Radiol. 2019 May;30(5):627-637.e1.
- Malling B, Røder MA, Brasso K, Forman J, Taudorf M, Lönn L. Prostate artery embolization for benign prostatic hyperplasia: a systematic review and metaanalysis.
Eur Radiol. 2019 Jan;29(1):287-298.
- Narayan V, Jung JH, Dahm P. Re: Efficacy and Safety of Prostatic Arterial Embolization: Systematic Review with Meta-Analysis and Meta-Regression: S. R.
Shim, K. J. Kanhai, Y. M. Ko and J. H. Kim J Urol 2017;197:465-479. J Urol. 2017 Jul;198(1):215-216.
- Wang XY, Zong HT, Zhang Y. Efficacy and safety of prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: a
systematic review and meta-analysis. Clin Interv Aging. 2016 Nov 11;11:1609-1622.
- Feng S, Tian Y, Liu W, Li Z, Deng T, Li H, Wang K. Prostatic Arterial Embolization Treating Moderate-to-Severe Lower Urinary Tract Symptoms Related to Benign Prostate Hyperplasia: A Meta-Analysis. Cardiovasc Intervent Radiol. 2017 Jan;40(1):22-32.
- Uflacker A, Haskal ZJ, Bilhim T, Patrie J, Huber T, Pisco JM. Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia. J Vasc Interv
Radiol. 2016 Nov;27(11):1686-1697.e8.