Minimally invasive BPH treatment shows promise

Prostatic artery embolization appears to show comparable clinical results to transurethral resection of the prostate without the associated risks, according to research presented at the Society of Interventional Radiology annual scientific meeting in Chicago.

"I believe that a minimally invasive interventional radiology treatment-prostatic artery embolization or PAE-will be the future treatment for BPH," said first author João Martins Pisco, MD, of Hospital Pulido Valente and St. Louis Hospital, Lisbon, Portugal. "Prostatic artery embolization blocks blood supply to treat BPH. This study is significant because it shows comparable clinical results to TURP without the risks of surgery, such as sexual dysfunction, urinary incontinence, blood loss, and retrograde ejaculation."

Dr. Pisco said patients experienced symptom improvement comparable to TURP. However, certain urodynamic results did not improve as much as with TURP.

"The best results are obtained on patients with prostates larger than 60 cc and with very severe symptoms," he added. "Pelvic arterial embolization may be the only feasible and effective treatment for BPH in those men who cannot have TURP due to the size of their prostate or because it is inadvisable for them to undergo general anesthesia."

In the study, 84 men (age range, 52 to 85 years) with symptomatic BPH underwent PAE after failing other medical treatments for at least 6 months. The men were followed for more than 9 months, and PAE was found to be technically successful in 98.5%. Two hours after PAE, most men were passing urine less frequently.

"There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure," Dr. Pisco said.