Prostate arterial embolization is a minimally invasive treatment for hypertrophy of the prostate. Through the microcatheter injection of microspheres to block the blood vessels of the prostate, the tissue ischemia and atrophy. Arterial embolization has a good therapeutic effect and is less invasive than traditional surgery. It only needs local anesthesia, the wound is only as big as a pinhole, does not require catheterization, and recovers quickly. It has fewer side effects and no surgery-related complications.

Symptoms of an Enlarged Prostate

       Do you or your family members have difficulty urinating, weak urination, or intermittent urination? Do you have difficulty holding back urine? Do you urinate frequently but not cleanly? Do you often need to get up at night to urinate and cannot sleep well? If you have the above symptoms, you may have an enlarged prostate.

     Prostatic hypertrophy is a problem that most mature men will encounter, and the probability increases with age. According to statistics, about half of men aged 50–60 and about 70% of men aged 60-70 have prostatic hypertrophy . Clinical symptoms are mainly related to urinary tract obstruction. Symptoms include: inability to urinate, intermittent urine flow, need to force the abdomen to force urine, inability to completely empty the bladder, frequent urination, urgency or frequent nocturia, which affect the quality of daily life. Severe cases may even lead to obstruction of the bladder outlet, urine retention requiring catheterization or obstruction leading to hydronephrosis, urinary tract infection or even renal failure.

Treatment for an Enlarged Prostate

  According to clinical treatment guidelines, drug treatment is generally given first. For patients who do not respond well to drugs, cannot tolerate drug side effects, or have severe initial symptoms, transurethral prostatectomy is a further treatment option. Now there is a new treatment method that can replace surgery - "prostate artery embolization".

Prostate Artery Embolization

     Prostate artery embolization is a procedure in which physicians use very thin catheters to enter from the hand or leg arteries, place microcatheters deeply in the tiny prostatic arteries, and then inject microspheres for embolization into the prostatic artery through the microcatheters. By blocking the prostate artery, the hypertrophic prostate tissue undergoes ischemia and atrophy. Then the volume of the prostate is reduced, and the obstruction of the urinary tract is relieved. The treatment time is about two hours.

    The advantages of arterial embolization include the fact that only local anesthesia is required and no semi-anesthesia is required. The wound is only as big as a pinhole, and the blood loss is less. Urethral catheterization is not required. The pain during and after the operation is mild. Only a short stay in the hospital is needed. It will not cause surgery-related complications such as urinary incontinence, urethral and bladder neck stenosis, sexual dysfunction, retrograde ejaculation, etc. After embolization, the use of prostatic hypertrophy drugs and related side effects such as postural hypotension or sexual dysfunction can be avoided or reduced. Arterial embolization is especially suitable for patients who want to receive minimally invasive treatment, elderly patients with high surgical or anesthesia risks, patients with cardiovascular diseases, those who need to take anticoagulants for a long time and have bleeding risks, and those who have doubts about surgery or anesthesia and are unwilling to undergo surgery Patients, those with busy work or life schedules who need to return to their original work or lifestyle as soon as possible.

     Prostate artery embolization has been practiced in Europe and the United States for many years, and the technology is quite mature. Rigorous and sufficient studies have confirmed its safety and effectiveness. It can effectively improve the clinical symptoms of prostatic hypertrophy, improve the quality of life, significantly increase the urine flow rate, reduce the volume of the prostate, and reduce the prostate specific antigen. Some patients will have temporary difficulty urinating, hematuria, or bloody stools within one week after the operation, and they will return to normal about one week after the operation. Eighty-five percent of the patients' symptoms related to benign prostatic hypertrophy can be significantly improved within half a month to one month, and seventy percent of the patients can maintain the effect for more than five years. The effect of improving symptoms is about the same as that of transurethral prostatectomy. The disadvantage of arterial embolization is the need to inject iodine-containing contrast medium, there may be concerns about renal function, and health insurance does not cover it.

 Conclusion

Division of Medical Imaging   Dr. Hsieh, ZhaoYu

Specialty: minimally invasive prostatic artery embolization, minimally invasive percutaneous lung tumor ablation, minimally invasive tumor embolization

Schematic diagram of minimally invasive prostatic artery embolization

Instructions before and after minimally invasive prostatic arterial embolization