• Posted March 2, 2023

Embolization Treatment Could Offer Drug-Free Relief From Enlarged Prostate

Men suffering from an enlarged prostate can receive long-term relief from a minimally invasive procedure that partially blocks blood flow to the gland, new research reports.

The procedure, called prostate artery embolization (PAE), dramatically improved urinary symptoms in patients without having any effect on erectile function, said senior researcher Dr. Shivank Bhatia, chair of interventional radiology at the University of Miami Miller School of Medicine.

PAE also improved the overall health of the prostate, Bhatia added.

"Medical imaging before and after the procedure showed a 32% reduction in size of the prostate gland at 12 months following the procedure,"Bhatia said.

"Additionally, the PSA [prostate-specific antigen] lab values showed a decrease of 42% at 12 months post-PAE,"he added. PSA levels are used to detect prostate cancer and signs of poor prostate health.

Results from 1,000 men who underwent embolization show that their relief was both significant and sustained, lasting through up to six years of follow-up, Bhatia said.

Bhatia will present these results Monday at a meeting of the Society of Interventional Radiology, in Phoenix. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

As many as 18 million U.S. men suffer from enlarged prostates, including more than 50% of men older than 60, researchers said in background notes.

The prostate gland naturally enlarges with age, putting pressure on a man's urethra, the tube that carries urine from the bladder. Symptoms of enlarged prostate can include urinary urgency, increased frequency, inconsistent flow, straining to urinate, and an inability to completely empty the bladder.

Drugs and surgeries are available to treat enlarged prostate, but these can come with side effects like erectile dysfunction or leaking, Bhatia said. As a result, many men with an enlarged prostate avoid treatment and simply grit out their discomfort.

In the PAE procedure, doctors inject tiny microparticles into the arteries that feed the prostate. This reduces blood supply to the gland, causing it to shrink. Doctors use X-rays and other imaging techniques to map the blood vessels of the prostate and guide the procedure, as they inject the microparticles into the prostate artery through the catheter.

The particles are made of acrylic polymer, Bhatia said, and are about the size of a grain of sand. They carry a charge that sticks them into the blood vessel where they are placed.

"Once you put them in, they don't move, they don't come off and let go into your brain or in your heart or anywhere else,"Bhatia said.

The participants were all quizzed on their prostate symptoms. Before the procedure, they reported an average symptom score of 23, which is in the "severe"range of the 35-point symptom scale used by the researchers.

But within three months, the patients achieved a "mild"score of 6, which persisted throughout the six-year study, results show. This response is similar to that achieved with invasive prostate surgery, but without affecting sexual function or causing leakage.

During six years of follow-up, between 5% and 15% of the men needed another treatment to maintain the benefits of PAE, Bhatia said.

"These are safe, effective, durable treatments, minimally invasive, and provide new options for patients that can be repeated if and when needed,"said Dr. Parag Patel, president of the Society of Interventional Radiology. "Quite frankly, the data today suggests that these are quite durable and beneficial for our patients."

More information

Johns Hopkins Medicine has more about prostate artery embolization.

SOURCES: Shivank Bhatia, MD, chair, interventional radiology, University of Miami Miller School of Medicine; Parag Patel, MD, president, Society of Interventional Radiology; Society of Interventional Radiology, news release, March 1, 2023