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New Relief for Prostate Enlargement


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New Relief for Prostate Enlargement

New Relief for Prostate Enlargement: Minimally invasive procedure requires only light sedation.

Published January 17, 2016
click here to view original artcle: ifoundmydoctor.com

A promising procedure that shrinks enlarged prostates offers a new treatment option for one of the most common health complaints of older men. The prostate is a male reproductive gland normally about the size of a walnut. It tends to grow larger, sometimes much larger, as men age. In fact, the condition occurs so frequently that more than half of all men are affected by an enlarged prostate by age 60. Prostate enlargement, also called benign prostatic hyperplasia, or BPH, is unlike prostate cancer in that it isn’t a malignancy. But for some men, it can have a strongly negative effect on their quality of life. 

“The most common issue that men start complaining about early on is needing to urinate frequently,” states Clifford R. Davis, MD, of Florida Interventional Specialists. “They may have to go five or six, maybe seven times during the day. When it really starts becoming an issue is when they wake up three or four times at night. At that point, it has been proven in sleep studies that deep REM sleep is interrupted, and men become sleep-deprived. “One of the things we always look at when evaluating patients is quality of life. If they’re having complications, such as urinary tract infections, or feeling tired all day from waking up so much, or experiencing frequent urination during the day or night, that’s when they need to seek treatment,” adds Dr. Davis.

The trouble starts with how an enlarged prostate affects the urethra, the tube that carries urine from the bladder to outside the body. The urethra passes through the prostate and is squeezed when the prostate grows. Not every man with an enlarged prostate is affected by symptoms, but for many, the urge to urinate becomes more frequent. At the same time, the condition can make it more difficult to fully empty the bladder. “Not being able to empty the bladder can lead to two things we’re really concerned about,” warns Dr. Davis. “It can injure the kidneys because they are constantly infected or not draining all the way. Sometimes, there is a sudden inability to urinate at all, which is called acute urinary retention. The urethra has become so tight that one day you wake up and it’s closed – this has to be treated as a medical emergency.”

Prostate Artery Embolization

Traditionally, enlarged prostates are treated with medications to relieve troublesome symptoms, or through surgery called transurethral resection of the prostate, or TURP. The surgery physically removes excess prostate tissue to create more space for the urethra.

At Florida Interventional Specialists, Dr. Davis and Shawn R. Meader, MD, are now treating patients with a new, minimally invasive procedure called prostate artery embolization, or PAE. The outpatient procedure is performed in less than two hours while the patient is under light sedation. Microscopic particles are injected through a catheter into the arteries that supply blood to the prostate. This results in reduced blood flow, which causes the prostate to shrink. “The technique is similar to how uterine fibroid tumors are treated through embolization,” says Dr. Davis. “Tiny particles are injected into arteries that supply the uterus, resulting in shrinkage of the fibroid growths.”

PAE has been used to treat men in Europe and South America. Dr. Davis and Dr. Meader have traveled to Brazil to train with Francisco Carnevale, a medical professor in Sao Paulo who is one of the world’s leading experts on PAE. The procedure is now in the evaluation process needed for approval by the US Food and Drug Administration. Florida Interventional Specialists is part of a multi-site study in the United States currently underway to evaluate the procedure’s effectiveness. Dr. Davis is also leading another FDA-approved study on the procedure at Tampa General Hospital.

The studies at Florida Interventional Specialists and Tampa General are being conducted in cooperation with USF Health Urology and Florida Urology Partners. As there are several diseases that can mimic the symptoms of BPH, including early prostate cancer, Dr. Davis always performs the procedure in cooperation with a local urologist to assure no other diseases are present which would not improve with the prostate embolization procedure. Urologists specialize in treatments of the lower urinary tract and offer tests that can differentiate disease.

“Most men feel that if they have difficulty urinating, they just have an enlarged prostate but that is not always the case,” notes Dr. Davis. Patients are being recruited for both studies. “The patient coordinator for the studies can discuss the procedure and evaluation process in more detail and discuss criteria,” says the doctor. “We think PAE is going to offer a great alternative to traditional surgery,” he continues. “The promising aspects are that currently there have been no reports of associated erectile dysfunction or serious bleeding associated with PAE. Those are two major risk factors of traditional surgery.”

Continued Improvements

Because PAE requires only light sedation, it’s safe for men with other significant health issues who aren’t able to undergo general anesthesia and therefore can’t have traditional surgery for prostate enlargement. “This is one of the big advantages of PAE over traditional surgery. We can perform PAE on patients who have heart disease, lung disease, cancer or other problems and need treatment for prostate enlargement just to improve their quality of life,” explains Dr. Davis.

Another favorable difference is that PAE only requires a urinary catheter during the procedure itself. Patients who undergo TURP may need a post-surgery catheter for one or more days. “With the PAE procedure, patients typically will notice a reduction in urinary symptoms after one to two weeks,” notes Dr. Davis. “Based on studies done outside the United States, symptoms will keep improving for three to six months as the prostate continues to shrink.

“Having a new treatment option may help men who are just trying to live with symptoms as best they can instead of seeking a solution,” says Dr. Davis.
“If you talk to men who are sixty and older, they all sit around and joke about how they have this condition,” he reports, adding that too often, men believe their only treatment alternatives are medications or traditional surgery. “They might try the medicine, then stop because of complications or side effects, but they decide not to have surgery because they don’t want to take the risk.

“Based on research outside of the United States and our early findings with PAE, we think it’s going to give men a great option for finding relief from prostate enlargement.”


Article Written By: Susan Hemmingway 
Published: January 17, 2016