Affecting about 60% of men over age 60, an enlarged prostate causes inconvenient symptoms including weak urine flow, dribbling and the frequent or urgent need to urinate. This condition is known as benign prostatic hyperplasia (BPH), and men who have it generally see a urologist for relief and discussion about the best course of treatment.
Traditional treatment options for BPH have included medications and surgery. Medications for BPH,which are not effective for some men and have many known side effects, fall into two main categories: alpha blockers and 5-alpha-reductase inhibitors.
- Alpha blockers (alfuzosin, doxazosin, prazosin, silodosin, tamsulosin, terazosin) may have side effects which include dizziness, especially upon standing up, drowsiness and headaches.
The surgical option, known as Transurethral Resection of the Prostate (TURP), is performed by urologists. With TURP, an instrument called a resectoscope is inserted through the tip of the penis and into the urethra to remove excessive growth areas of the prostate that affect urinary flow. TURP is considered by many medical professionals to be a rather barbaric procedure, and some patients may have a personal desire not to have this surgery or may have other medical conditions that rule out traditional surgery.
- 5-alpha-reductase inhibitors (finasteride, dutasteride) are associated with an increased risk of developing certain forms of rare, but serious, prostate cancer and sexual dysfunction, and emotional issues that include depression, anxiety and the potential for self-harm.
A third treatment option, Prostate Artery Embolization (PAE), works significantly better than medications for BPH, and has emerged from the medical arena of interventional radiology. For many years, interventional radiologists have used embolization techniques in other parts of the body, e. g., uterine fibroid embolization for women. They are able to use this experience, along with their considerable knowledge and skills, to successfully perform PAE for men.
At SIR, Florida’s premier radiology practice located in Sarasota, interventional radiologist Dr. Gerald E. Grubbs performs PAE to treat enlarged prostate without the risk of sexual side effects. Dr. Grubbs has worked with leading urologists for many years to provide treatment alternatives for both BPH and prostate cancer. This interdisciplinary, collaborative approach focuses on the welfare of the patient and helps to determine which treatment best fits each individual patient.
PAE is a minimally invasive procedure approved by the FDA, during which a catheter is inserted into the groin and, with imaging guidance, is directed to the prostatic arteries where microscopic particles are carefully injected. The skills of the interventional radiologist are paramount to ensure that the injected particles stay only in the prostatic arteries.
The tiny particles remain in the prostatic arteries permanently, blocking blood supply to areas of the prostate affected by BPH. The result is a reduction in the size of the prostate by about 30-40%, thereby alleviating some of pressure on the urethra and no longer obstructing the flow of urine from the urethra. This process is called embolization. Relief is generally noticed within one to two months, and more significant relief is felt within three to six months. Up to 80% of men who undergo the PAE treatment experience improvement.
To help keep the patient relaxed and comfortable, Dr. Grubbs performs PAE with conscious sedation administered by SIR’s board-certified anesthesiologists. The procedure generally lasts one to four hours, depending on the size of the prostatic arteries, followed by several hours in recovery. Driving is prohibited for 24 hours after the procedure, so a driver is needed to take the patient 内蒙古快3.