What are the current treatment options for BPH?
As men grow older, their prostate begins to naturally enlarge, for a number of reasons. As the gland grows, it can put pressure on the bladder and squeeze the urethra, causing a lot of urinary problems.
These common urinary symptoms include:
In some cases this can become incredibly debilitating, with some men needing to visit the bathroom every hour, even during the night!
There are actually a wide variety of treatment options for an enlarged prostate, and the choice of these can depend on the size of your prostate, your age and the severity of your symptoms.
In some cases medication such as 5α-reductase inhibitors, which act as antiandrogens (androgens are male sex hormones) are used to help reduce the size of the prostate. However, these are often associated with unpleasant side effects such as loss of libido, erectile dysfunction and even depression.
There are some surgeries too, which can involve removing the whole prostate, removing part of the prostate or treating the prostate with heat. However, as with any surgery, these come with a greater degree of risk, have a longer recovery period, and some methods also involve introducing instruments through the penis – not so pleasant!
One treatment that is relatively new and less widely used is Prostate Artery Embolization (PAE), but recent research has shown some promising results regarding this treatment.
What does Prostate Artery Embolization involve?
Prostate Artery Embolization involves blocking the arteries that feed the prostate, so that the gland begins to shrink due to reduced blood flow.
To do this, a catheter is inserted into an artery (often in the thigh or groin) and directed to the prostate gland. Once there, microscopic beads are deposited to block the blood flow to parts of the prostate. As blood flow reduces, the prostate shrinks. It requires only local anaesthetic and has few short or long-term side effects.
What does the new research show?
Patients were evaluated for the short-term, medium term and long term success of the procedure, and the researchers found that the treatment had a success rate of 89% in the short term, 82% in the medium term and 78% in the long term1.
They found no effect on sexual function, and noted that the treatment is particularly effective for those experiencing acute urinary retention and those with very large prostates.
However, the researchers highlighted that this treatment is not suitable for those with arterial atherosclerosis, which is where the arteries become narrowed by fat or plaque. This is most common in overweight adults, people who smoke or those on highly fatty diets.
Is Prostate Artery Embolization available to me?
PAE is currently not a particularly common treatment for an enlarged prostate, and as of last year only 16 UK hospitals in the UK were offering the procedure2. This may have increased by now, so it may be worth speaking to your GP to find out if this treatment could be available to you.
Since this research has shown such positive results, I hope that this form of treatment will become more widely available over the coming years.
Are there natural alternatives?
If you’re not keen on any of the conventional treatments, then Saw Palmetto could help you. This handy herb is traditionally used to reduce the symptoms of an enlarged prostate such a frequent urination and nocturia (getting up during the night to use the toilet). It is not known to be associated with the negative side effects of many conventional BPH treatments.
1) Society of Interventional Radiology. "Nonsurgical treatment for enlarged prostate remains effective for years: Prostate artery embolization relieves urinary symptoms of BPH without causing major side effects." ScienceDaily, 8 March 2017.
2) Colchester University Hospital 'Mike benefits from new prostate procedure', 22 November 2016
