Arterial Embolization for Enlarged Prostate

Prostate Arterial Embolization (PAE) is a minimally invasive therapy for men suffering from enlarged prostates offering lower risks and side effects posed by existing treatments.

July 19, 2015

Arterial Embolization for Enlarged Prostate: New Treatment Studied for Long-Term Safety, Effectiveness
By Leslie A. Whitlinger

Arterial Embolization
Ron and his wife, Assiya

Four years ago, a new approach to urinary obstruction from an enlarged prostate debuted in Portugal with encouraging results. Called Prostate Arterial Embolization (PAE), the minimally invasive therapy promises men an appealing alternative to the risks and side effects posed by existing treatments. The physicians and scientists at MedStar Georgetown University Hospital set out to study the procedure. And Ron Simmons of Woodstock, Va., was quick to opt into the study.

In 2014, the hospital, in conjunction with Georgetown University Medical Center, became the first in the U.S. to launch an FDA-authorized clinical trial of the new procedure. Through the study, investigators want to verify that PAE causes no injury to the nearby bladder or rectum, as well as determine the treatment’s long-term effectiveness. “It’s the only responsible way to assure that we’re practicing medicine based upon solid, replicable evidence,” says James Spies, MD, principal investigator, chair of Radiology at MedStar Georgetown, and a pioneer in a closely related and widely used procedure, uterine fibroid embolization. “This is a safe and successful approach to an enlarged prostate. It could become a viable, non-invasive alternative to more drastic treatments like TURP—partial removal of the prostate through the urethra—or open surgery.”

The National Institutes of Health reports that more than half of men in their 60s, and 90 percent in their 70s and 80s, suffer from enlarged prostate, formally called benign prostatic hyperplasia or BPH. As prostate tissue overgrows, it squeezes or even blocks the urethra, resulting in difficulty urinating, a more frequent urge to urinate, increased nighttime urination and/or a weak urine flow. Neither cancerous nor lifethreatening, BPH can nevertheless cause severe symptoms that substantially affect quality of life.

That was certainly the case for Ron. “I was already taking the maximum medication for my enlarged prostate but was still miserable,” says the active 69-year-old. “I was concerned about the side effects and potential problems associated with surgery. Then I stumbled onto PAE while doing web research, and it seemed like a no-brainer to me. I would have traveled to Europe if that was the only way I could get it.”

Enlarged Prostate
Ron’s discomfort no longer rules the road.

Fortunately for Ron, the relief he sought was only about 100 miles away. He immediately applied to be in the clinical trial, and became one of fewer than 300 men in the U.S. to date to be treated with PAE, still labeled an “Investigational Device.”

During PAE, small beads are injected through the large artery at the top of the leg into the smaller arteries leading into the prostate. The beads then block the blood supply, depriving the enlarged prostate of nourishment. As the prostate starts to shrink away from the urethra, it relieves the pressure that caused the problems.

“After PAE, I was uncomfortable for about 7 to 10 days, but within about two weeks, I was a new man,” Ron says. “A year later, my prostate continues to shrink and my PSA levels have dropped to 3.4 from around 5.9 before the procedure. I couldn’t be happier with my decision or the results.” As part of the study, Dr. Spies and his fellow researchers measure symptoms immediately before and after PAE, then follow participants for up to five years to determine if symptoms return.

“If we can definitely show that prostate arterial embolization is safe and effective, the impact will be substantial,” Dr. Spies concludes.

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