Enlarged Prostate Treatment Protected Fertility

Prostatic artery embolization is minimally invasive and led to fewer complications than surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) More than half of men will have an enlarged prostate by the age of 60 years. Standard treatment for this condition usually involves surgery that can cause uncomfortable and even permanent side effects. Now, there may be an alternative.

A new study found that there may be a safe alternative to prostate surgery. That alternative is called prostatic artery embolization, which is a minimally invasive, outpatient procedure that involves shrinking the prostate by temporarily blocking blood flow to the prostate.

The researchers discovered that prostatic artery embolization did not cause sexual dysfunction, and it preserved fertility in men.

"Get your prostate checked regularly."

The lead author of this study was Joao Martins Pisco, MD, PhD, from Saint Louis Hospital in Lisbon, Portugal.

The study included 469 men between the ages of 45 and 89 years old who underwent prostatic artery embolization (PAE) for an enlarged prostate gland and lower urinary tract symptoms. The average age of these men was 70 years old.

The prostate is a male sex gland that lies underneath the urinary bladder and produces fluid for semen. A healthy prostate is the size of a walnut.

Enlarged prostates can cause urinary frequency, urgency, passing urine more often, weakened stream and incomplete bladder emptying — symptoms that can significantly lower quality of life, according to Dr. Pisco and team.

Prostate volume ranged from 35 to 269 cubic centimeters (cc), and the average prostate volume was 92 cc. The average range for a healthy male adult is 20 to 30 cc. A prostate volume over 40 cc is considered enlarged.

The researchers evaluated the men before PAE, at one month afterwards, at three months afterwards, at six months afterwards and every six months thereafter.

Follow-up was conducted from three to 52 months; the average follow-up period was 20 months.

The findings showed that 87 percent of the men had symptoms under control by three months after PAE.

By 18 months, 80 percent of the men had controlled symptoms.

By three years after the procedure, 72 percent of the men had experienced significant symptom improvement and control.

A total of 23 percent of the men's procedures did not work. However, the researchers maintained that men can often be re-treated with PAE if the procedure fails or has complications the first time around.

"The results of PAE are similar to surgery but with fewer complications," Dr. Pisco said in a press statement. "Patients are discharged three to six hours after the treatment with most of the individuals we've treated noting almost immediate symptom relief," he said, adding, "I believe PAE could eventually become standard treatment for enlarged prostate."

"Our study confirmed that PAE does not cause sexual dysfunction and preserves fertility," said Dr. Pisco. "We also found that the larger the prostate and the more severe the symptoms are, the better the results of PAE." 

This study was published in the March edition of the Journal of Vascular and Interventional Radiology. It was also presented at the Society of Interventional Radiology's 39th Annual Scientific Meeting on March 24.

Review Date: 
March 24, 2014
Last Updated:
March 25, 2014