Prostate Artery Embolisation (PAE

A Revolutionary treatment for the enlarged prostate (BPH) which will put your life back on track without the feared side effects!

WORDS DR. MANUELA ELENA REISBECK

BENIGN PROSTATIC HYPERPLASIA

Benign prostatic hyperplasia, also known as BPH, is a benign growth of the prostatic gland. It is the most common benign tumor found in the Western male population. It affects 25% of men age 55+ and up to 50% after the age of 75. Although not life threatening, it can cause numerous symptoms of varying severity, as a result of the partial constriction of the urethra by the enlarged prostate. Frequent and even painful urination, especially at night, urgency and dribbling are the most common annoying problems caused by BPH. Urinary incontinence (loss of bladder control), frequent urinary infections and bleeding from the bladder are more serious and often require treatment to prevent complications. Traditionally, the regimen of choice would be surgery or laser treatment

of the prostate, to debulk the gland and set the urethra free again. Both procedures cause direct damage to the prostate and the area adjacent to it, which is why many men prefer tolerating the symptoms rather than having to deal with the side effects of the treatment procedure itself, like urinary incontinence, urinary bleeding, and the most feared, erectile dysfunction and retrograde ejaculation. The prostate artery embolisation (PAE) on the other hand is a minimally invasive, endovascular intervention which does not touch the prostate or the tissue adjacent to it. Simply put, it is the blockage of the arteries of the prostate, reducing blood flow to the gland and therefore facilitating shrinking of the tissue as a ‘normal’ response to decreased blood supply. Because there is no damage to the prostate from the outside, the risks of side effects affecting the erectile function, retrograde ejaculation, or the urinary system, are very low. PAE is performed by an interventional radiologist rather than by a urologist – a doctor who uses X-rays to navigate inside the body and treat conditions without surgery. A small catheter will be inserted into the artery of the wrist or the groin. There will be no cut and no wound. Small straw like catheters will then be used to reach the vessels which supply the blood to the prostate. When identified, tiny round particles are injected through the catheter into the blood vessel, which will then be occluded. All catheters are then removed and the patient can go home the same day. With blood supply being reduced, the prostate will start shrinking and debulking, freeing the urethra and alleviating previous symptoms.

WHO SHOULD GO FOR PAE?

As PAE does not require anesthesia and does not involve surgical cuts and wounds, it is of course indicated for older patients who have a higher risk undergoing surgery, because of other concurrent conditions or because of medications taken, like blood thinners. It is also indicated for younger, active patients who do not wish to endure the risks of urinary and sexual side effects of the standard treatment options. For patients with urinary bleeding due to BPH, the PAE procedure can even be seen as the treatment of choice. In general, undergoing PAE is not a one-way road; other prostate interventions can be performed at a later point in time, if necessary – while patients who underwent prostate surgery and suffered side effects will not benefit from PAE anymore. It is not indicated as a treatment for prostate cancer. Although not well known to most affected patients, PAE is not a new procedure. It has been studied for more than 15 years and the positive results have been presented in numerous scientific publications. UroCare, the urology branch of the endovascular clinic CardioCare Marbella, is dedicated to PAE and is the only centre in Marbella offering this technologically advanced treatment modality. We work as a team of international urologists and interventional specialists and we do understand that when it comes to prostate treatments, modern men of all ages do welcome a solution which will put their life back on track without harmful side effects.

i For more detailed information on this matter, see www. urocaremarbella.com or www. cardiocaremarbella.com