Here's how a new non-surgical procedure for treating an enlarged prostate works

A new procedure – prostate artery embolisation (PAE) – has been approved by the the UK’s National Institute for Health and Excellence and this is expected to encourage health authorities to adopt the procedure throughout Europe.

Brazil and the U.S. have already approved PAE therapy in 2016 and March 2018 respectively.

The procedure uses tiny plastic beads to restrict the blood supply and shrink an enlarged prostate gland, giving men an alternative to surgery.

Generic imagery of a doctor and patient during consultation

An enlarged prostate presses on the bladder, while also blocking the urethra. Sufferers need to make repeated night-time trips to the toilet, but often find they cannot urinate at all. The condition, known as benign prostatic hyperplasia (BPH), affects about 50% of men over the age of 50, rising to 75% over 80, although not all affected men experience symptoms.

PAE therapy, performed by an interventional radiologist rather than a surgeon, is an alternative to transurethral resection of the prostate (TURP), an operation to shrink excess prostate tissue that is blocking urine flow.

PAE involves guiding a 1mm flexible tube known as a micro-catheter, under local anaesthetic, into the femoral artery in the groin and then in to the prostatic arteries, aided by sophisticated 3D X-ray technology to ensure accurate positioning.

Once in place, the arteries are blocked by injecting a solution of microscopic particles - 0.2mm plastic beads - which partially reduce the blood supply. The reduction in blood supply induces the gland to shrink in size over time.

The procedure is quick — PAE takes approximately 2 hours to perform, and the patient can be discharged after 4 hours provided he is fit, whereas surgery may require an overnight stay or longer. PAE also eliminates some of the common side effects of TURP, such as sexual dysfunction, infertility and transient incontinence.

Graphic News & Digital Desk


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