Not many people know, but half of all men age 50 or more suffer from a benign enlarged prostate and the chance this will happen only goes up as one get older. The good news is that today, this issue can be treated with an innovative method that allows for quick recovery, minimal risks and most importantly, doesn't impair sexual function.
The prostate gland is part of the male reproductive system. It lies under the bladder and it wraps around the urethra. Benign enlargement is a condition where the volume of the prostate increases as a natural part of human aging, just like most men have receding hair. The increased volume impacts the urethra, located at the center of the prostate. As a result, it can make urination difficult.
About 50% of men aged 50 will suffer from this condition and as you get older, it becomes even more common.
What are the symptoms and how does treatment work?
Common symptoms of benign prostatic hyperplasia include difficulty urinating, weak urine stream, repeated and frequent feelings of urgently needing to urinate, and feeling like you can't empty the bladder. In some cases, it's possible for urinary retention to occur, a condition that requires the urgent insertion of a urinary catheter.
Treatment starts with lifestyle changes like avoiding drinking coffee and alcohol in the evenings and especially before going to sleep. If this treatment doesn't lead to improvement, you can take medications that can help, but this only helps a bit because at some point, their effect diminishes. Sometimes there are also side effects to the medications, such as decreased sexual function or breast enlargement.
Surgical treatment options
If medication no longer helps, you can undergo surgery to remove the prostate. There are two common surgical procedures for this. One is a closed resection, which is suitable for a prostate with a volume of 30-80 cc. The operation is performed under anesthesia, during which a camera is inserted through the urethra. After that, parts of the prostate are cut with another device inserted into the urethra, with the aim of opening the scar tissue that stops you from urinating fully.
The second method is an open resection through the lower abdominal wall, which is usually suitable for a prostate larger than 100 cc. As with any surgery, this operation comes with risks such as infection, bleeding, impaired sexual function, posterior ejaculation and urine leakage. Recovery time after surgery varies and ranges from 2-8 weeks.
Over the years, there have been many attempts to develop new methods and produce technologies to allow for invasive treatment with minimal risk, with high chances of success, and without lasting side effects. A cutting-edge technology called prostate artery embolization presents an innovative approach to treating this issue without surgery. This is a safe and effective procedure to treat lower urinary tract symptoms and urinary retention as a result of benign prostate enlargement.
Since its development, many studies have been published that have shown that the results of embolization are similar to surgery, and even superior in helping with urination. This procedure is more comfortable than conventional treatments. It's performed under local anesthesia and sedation, there's no need to insert a urinary catheter, it can be performed on any prostate volume over 35 cc, and it doesn't hinder sexual function.
The hospitalization and the duration of the recovery period are short. In addition, the possible complications from this operation are extremely rare. This is undoubtedly a significant breakthrough for treating an enlarged prostate.
Dr. Zalman Itzhakov is a department manager and invasive radiologist at Medica Elisha Haifa.