Prostate

The prostate is a small, walnut-shaped gland located between the bladder and the penis. It surrounds the urethra, the tube responsible for carrying urine and semen out of the body. The prostate plays a key role in male reproductive health by producing fluid that nourishes and transports sperm.

As men age, particularly after 40, the prostate often enlarges, a condition known as benign prostatic hyperplasia (BPH). While BPH is non-cancerous, it can lead to uncomfortable urinary symptoms. Studies show that approximately 50% of men aged 51–60 and up to 90% of men over 80 experience prostate enlargement. If left unmanaged, BPH can significantly impact quality of life.

Symptoms of BPH include:

Symptoms of BPH

An enlarged prostate can compress the urethra, leading to urinary symptoms such as:

• Frequent urination, especially at night (nocturia)

• Difficulty starting urination

• Weak or interrupted urine stream

• Incomplete bladder emptying

• Urinary urgency or leakage

• Dribbling after urination

• Urinary retention (inability to urinate)

Lifestyle Modifications for Managing BPH

While BPH cannot be entirely prevented, certain lifestyle changes can help manage symptoms:

• Limit alcohol and caffeine: These can irritate the bladder and worsen symptoms.

• Stay hydrated, but time fluid intake: Avoid drinking large amounts before bedtime.

• Avoid decongestants and antihistamines: These can tighten the muscles around the urethra, making urination difficult.

• Exercise regularly: Physical activity supports overall health and may reduce BPH symptoms.

• Practice double voiding: Urinate, wait a few moments, and try again to empty the bladder fully.

• Respond promptly to the urge to urinate: Delaying can strain the bladder.

Diagnosis of BPH

Diagnosing BPH typically involves:

• A physical exam, including a digital rectal exam (DRE) to assess prostate size.

• Urine tests to rule out infections or other issues.

• Blood tests, such as a prostate-specific antigen (PSA) test, to screen for prostate cancer.

• Imaging tests, like ultrasound, to evaluate the prostate and bladder.

Treatment Options for BPH

Treatment depends on the severity of symptoms and the patient’s overall health. Options include:

1. Medications

• Alpha-blockers: Relax prostate and bladder muscles to improve urine flow.

• 5-alpha reductase inhibitors: Shrink the prostate over time by reducing hormone-related growth.

2. Minimally Invasive Procedures

• Prostatic Artery Embolization (PAE): A non-surgical procedure where an interventional radiologist inserts a catheter into the groin to block blood flow to the prostate, shrinking it and relieving symptoms. PAE offers advantages such as:

  • Minimal invasiveness

  • No visible scarring

  • Shorter hospital stays (often overnight)

  • Faster recovery and lower risk of complications

  • High success rates (84% within six months)

• Transurethral Microwave Therapy (TUMT): Uses heat to reduce prostate tissue.

• Laser Therapy: Removes excess prostate tissue with laser energy.

3. Surgical Options

• Transurethral Resection of the Prostate (TURP): Removes prostate tissue through the urethra.

• Open Prostatectomy: Reserved for severely enlarged prostates, involving surgical removal of part of the prostate.

Why Consider Prostatic Artery Embolization (PAE)?

PAE is gaining popularity as a less invasive alternative to traditional surgeries. It involves:

1. Making a small incision in the groin.

2. Inserting a catheter into the blood vessels supplying the prostate.

3. Using tiny beads to block blood flow to the enlarged areas, reducing prostate size.

4. Utilizing cone beam CT imaging for precise placement of embolic agents, minimizing risks.

PAE is performed by an interventional radiologist and is ideal for patients seeking a quicker recovery with fewer complications.