Blood Vessel Treatment Might Reduce Symptoms of Enlarged Prostate
WEDNESDAY Jan. 22, 2014, 2014 -- A new nonsurgical treatment for enlarged prostate might help ease symptoms such as frequent urination at night, Brazilian researchers report.
Enlarged prostate -- formally known as benign prostate hyperplasia -- affects most men as they age, including more than half by age 60 and 90 percent by age 85. Problems caused by enlarged prostate include frequent urination, weak urine stream and a constant feeling of having to urinate.
The new treatment -- called prostate artery embolization -- shrinks the prostate by temporarily blocking blood flow to the arteries that feed it, the researchers said, and can be done using a local anesthetic. The findings were scheduled to be reported Wednesday at the International Symposium on Endovascular Therapy, in Miami.
Doctors at the University of Sao Paolo said they have used prostate artery embolization to treat 120 patients with an enlarged prostate, and 97 percent of the men have experienced improvements in symptoms and quality of life.
"We have treated more than 100 patients with [prostate artery embolization] and are encouraged by the excellent reduction in symptoms and improvement in quality of life for men who have had the procedure, including some with very large prostates who normally would require open surgery," Dr. Francisco Carnevale, associate professor of medicine at the university, said in a symposium news release.
The patients were followed for an average of 15 months. Symptoms recurred in 14 percent of the patients, and they had to undergo surgery or drug therapy, or have the procedure done again, according to the study.
"[However], none of our patients have experienced adverse side effects, and we have followed a number of them for several years -- longer than other studies," Carnevale said.
Experts had mixed views on the new therapy.
Dr. Ash Tewari called it "promising." He added, however, that "there are already several time-tested treatments available that give a wide variety of options to these men."
Tewari, chairman of the urology departments at the Icahn School of Medicine at Mount Sinai and Mount Sinai Hospital in New York City, said the study is small, "and we need to evaluate these findings in larger trials comparing various treatments."
Dr. David Samadi, chairman of the department of urology at Lenox Hill Hospital in New York City, said the study had some flaws. It was comparatively short with short follow-up visits, patients may experience pelvic pain and there is a risk that the embolization beads used in the therapy might "migrate through the patient," he said.
"Until the length of the study is available to larger groups and the data is available," he said, other established treatments might still be a patient's best option.
Prostate artery embolization is not yet approved for use in the United States. According to the researchers, another study is currently under way to compare the therapy with the standard surgical treatment for enlarged prostate.
Experts note that studies presented at medical meetings typically are considered preliminary until published in a peer-reviewed journal.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about enlarged prostate.
Posted: January 2014
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