Newswise — LOS ANGELES (Jan. 10, 2024) -- The choices that Bruce Gold faced last December to resolve debilitating symptoms from a severely enlarged prostate were to keep using a catheter or have an invasive surgery with unreliable results and a high risk of complications and lingering side effects.
Neither option was appealing.
Luckily, Gold’s urologist recommended a different treatment option: prostate artery embolization. The urologist referred Gold to H. Gabriel Lipshutz, MD, a Cedars-Sinai interventional radiologist who specializes in the minimally invasive, low-risk procedure that uses tiny beads to block blood flow to the prostate, allowing it to shrink.
“Prostate artery embolization offers a dramatic improvement in quality of life for men whose symptoms are severe enough to affect their lives and the medication they’ve been using is not effective or causes unwanted side effects, or surgery is not an option for them,” Lipshutz said.
Gold was a good candidate for the outpatient procedure, which took about two hours and left him “exuberant” about being free of symptoms, side effects—and the catheter.
“Ten days after the procedure, there was definite improvement,” Gold said. “Three weeks later, I was a very happy camper. And today, my symptoms are completely gone.”
Enlarged prostate, or benign prostatic hyperplasia (BPH), is common in men as they get older. About 50% of men have the condition at age 50, and the percentage increases with age. Most men have an enlarged prostate by the time they’re 80, according to the National Institutes of Health.
As the prostate gland grows, it presses on the urethra—the tube that carries urine from the bladder and out of the body. The result is often a weak urine stream, difficulty emptying the bladder completely, and difficulty urinating despite feeling an urgent need. Some men do not experience symptoms bothersome enough to seek treatment. But for others, like Gold, the symptoms become detrimental to their quality of life.
“You can either live with your symptoms, or you can’t,” Lipshutz said. “Men who can’t live with their symptoms seek treatment.”
It had been more than two decades since Gold, 68, had had a normal urine flow. Medication helped for a while, but over time it became less effective.
Then one day late last year, Gold rushed to the hospital.
“My symptoms were as extreme as you can get—I was not able to urinate at all,” Gold said. “The suffering was unreal.”
Imaging revealed that his prostate was extremely large—too large, in fact, for some treatments. So a catheter was inserted, which Gold lived with for three months until the successful prostate artery embolization.
A Dramatically Improved Quality of Life
Prostate artery embolization is a complex procedure performed by highly trained specialists like Lipshutz. He makes a small incision in the wrist and a mini-catheter is inserted into the radial artery and then guided, using X-ray technology, through the body to the arteries that feed blood to the prostate. Microscopic beads are then injected into those arteries from the catheter to block the flow of blood.
Because prostate artery embolization is a relatively new treatment for BPH, long-term research data is not yet available. However, clinical trials have shown the procedure to be highly effective. Patients’ urinary symptoms can continue to improve for up to six months afterward.
Complications are rare, there is virtually no risk of the incontinence or impotence that can accompany traditional surgery, and recovery time is minimal, Lipshutz said.
“Some of my patients are almost in tears because they are so happy with the results,” Lipshutz said. “These are people who were severely affected by their symptoms—not being able to sleep at night because they wake up several times to go to the bathroom, for example.
“They can’t believe how their lives have changed. Many ask, ‘Why didn’t I do this sooner?’ or [say], ‘I wish I had been aware of this procedure sooner.’”
Lipshutz partners with urologists to ensure that patients with enlarged prostate are informed of all treatment options and are treated optimally, based on each person’s individual needs.
Gold is grateful his urologist referred him to Lipshutz.
“This procedure was a godsend,” he said. “I’m back to where I was over 20 years ago. It’s changed my life.”
Read more on the Cedars-Sinai Blog: Why You May Have Trouble Peeing, Plus Solutions to Help
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