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Nonsurgical Treatment for Benign Prostatic Hyperplasia

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Prostatic Artery Embolization provides new options for men with enlarged prostate glands.

Doctor speaks with male patient.

If you’re a man over 50, you have a one in three chance of having benign prostatic hyperplasia (BPH), the most common benign tumor found in men. BPH causes symptoms such as lack of bladder control, increased urinary frequency, and urgency and pain. For those with minor symptoms, medication or diet changes can help, but as symptoms increase, surgery is often the next step.

But for men who are not candidates for surgery, or have a strong desire to avoid surgery, prostatic artery embolization (PAE) is a new treatment option.  

Interventional radiologist Brian Holly, M.D., explains what you should know about the prostatic artery embolization procedure and if it may be right for you.  

Q: What is PAE?

A: PAE is a nonsurgical procedure that decreases the blood supply to the prostate, thus reducing its size and symptoms. An interventional radiologist, who uses X-rays and other imaging techniques to see inside the body and treat conditions without surgery, performs PAE. At Johns Hopkins, our interventional radiologists are expertly trained and experienced in performing this technically challenging procedure.  

Q: Who is eligible for PAE?

A: The PAE procedure is best for candidates who are either ineligible due to pre-existing health conditions or not interested in traditional surgery. An exam with an interventional radiologist can determine if you are a candidate for PAE. At this appointment, you may be asked how often you have urinary symptoms of BPH, how severe they are, and how much they affect your quality of life. Men who have advanced heart diseases associated with smoking or diabetes may not be candidates for PAE.

Q: What are the benefits to PAE?

A: PAE is less invasive then other procedures so patients can return to their normal lives sooner. The PAE procedure can also have a lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction), when compared with more invasive surgical procedures such as a TransUrethral Resection of the Prostate (TURP).

Q: How effective is PAE?

A: PAE is a new and promising procedure.  In a study published in 2016, 630 patients underwent a prostate artery embolization procedure.  The study found that the procedure had a positive effect on urinary symptoms as well as overall quality of life.  This positive effect lasted 1-3 years in 82% of the patients and lasted 3-7 years in 76% of the patients.  Additionally, there was no urinary incontinence or sexual dysfunction reported.

With the high success rate of PAE, men ineligible for surgery are able improve their quality of life by eliminating or reducing uncomfortable BPH symptoms. Be sure to speak to your urologist to help determine the best approach for you.

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