No-Scalpel Treatment for Enlarged Prostate

March 29, 2011 -- A minimally invasive procedure that cuts off the blood supply to an enlarged prostate may help when medications fail, and it appears to provide good symptom control without sexual dysfunction, a new study shows.

The procedure involves using a tiny catheter that is threaded through arteries near the groin to reach the vessels that supply the prostate with blood. These vessels are then blocked with particles the size of a grain of sand.

A similar procedure is sometimes used to treat another kind of benign growth, uterine fibroids, in women.

“It was my inspiration -- uterine fibroids. It’s the same kind of growth,” says study researcher Joao Martins Pisco, MD, chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal. “The results are excellent.”

In a small pilot study, most men were able to leave the hospital four to eight hours after the procedure, which is called prostatic artery embolization (PAE), researchers report.

PAE reduced the symptoms of frequency and urgency of urination without causing side effects like incontinence, sexual dysfunction, retrograde ejaculation (ejaculation into the bladder), or bleeding.

Despite the promising results of this small trial, experts said it was far too early to recommend PAE to patients.

“There are a lot of questions. We really don’t know what the short- and long-term success or complication rates are,” says Anthony Malizia Jr., MD, president and director of the Malizia Clinic, a nonprofit urology specialty center in Atlanta. “We don’t know how well these particles are localized to the prostate or if they’re going to the pelvis or other parts of the body.”

Malizia notes that in one serious complication reported in the study, the particles appeared to migrate and kill a small part of the bladder wall. The authors report that the dead tissue required surgical removal.

The study was presented at the Society of Interventional Radiology annual meeting in Chicago.