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Pioneering prostate treatment

Tiny plastic particles the size of fine grains of sugar are bringing relief to men with enlarged prostates, writes Judy Hobson

Men with what is called benign prostatic hyperplasia often have to get up several times a night to urinate, disrupting their sleep and making them irritable and depressed.

With age, the prostate gland increases in size and starts to press on the urethra – the tube that connects the bladder to the penis. This causes the man not only to experience a frequent and urgent need to urinate but also to often have poor flow. Sometimes an enlarged prostate can block urinary flow completely and the man has to be rushed to hospital and have a catheter put in.

Men diagnosed with benign prostate hyperplasia are initially prescribed drugs called alpha blockers to shrink the prostate or 5-Alpha reductase inhibitors for testosterone which may be feeding the enlargement. However, while these are effective for some patients, others can’t tolerate them because of their side-effects such as erectile dysfunction and low libido. This group is then offered surgery to remove part of the prostate in an operation called Trans-Urethral Resection of Prostate – TURP.

A medical team at Southampton General Hospital is pioneering a new treatment, called prostate artery embolisation, for the condition that affects thousands of older men. The team, led by interventional radiologists Dr Nigel Hacking and Dr Tim Bryant and urologist Mr John Dyer, uses tiny plastic particles to block off arteries that feed the prostate gland. They are the first in the UK to use this non-surgical procedure to treat men suffering from the severe effects of having an enlarged prostate.

A fine catheter is inserted into the patient’s groin and particles, one tenth of a millimetre in diameter, are fed into arteries either side of the prostate gland, gradually blocking them off. This cuts off some of the blood supply to the enlarged prostate, reducing it in size by around 30 per cent, and means the patient does not need to urinate so frequently.

Dr Hacking says: “When lifestyle changes such as reduced fluid intake and medication are unsuccessful, thousands of men in the UK have to undergo surgery, often resulting in long recovery periods and side-effects.

“This new procedure allows us to halt symptoms non-surgically in a one to two-hour procedure done under local anaesthetic which sees the patient going home four to six hours later.” The new technique was first carried in Brazil in 2009 and has been used to treat more than 400 patients in Portugal.


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