Half of men 50 and older struggle with enlarged prostate, or BPH, and its uncomfortable symptoms. Prostate artery embolization (PAE) is a minimally invasive procedure that can bring significant improvements for men with an enlarged prostate. Dr. Hsu, a radiologist with ARA Diagnostic Imaging, discusses this leading-edge approach with KEYE-TV’s Trevor Scott on CBS Austin’s ‘We Are Austin.’
Trevor Scott: Welcome back to “We are Austin.”
Well, the month of June is men’s health month. And one of the most important parts of men’s well-being is prostate health. You hear that a lot. And as men get older, they may find that they’re having the uncomfortable symptoms of enlarged prostate.
Dr. Connie Hsu from ARA diagnostic imaging is joining us today to talk about prostate artery embolization, or PAE, which is a minimally invasive, leading-edge procedure that can bring significant improvements for men with enlarged prostate.
This is great. Good morning to you doctor. Thank you so much for joining us.
Dr. Hsu: Thanks for meeting with me.
Trevor: Well, I think this is a very important topic probably year-round, right? But since it is June and men’s health month, let’s dive in and talk a little bit about it. Maybe beginning kind of high level.
What is in an enlarged prostate?
Dr. Hsu: Well, the prostate gland gets bigger as men get older. And in medical terms, benign prostatic hypertrophy, or BPH, is what we call it. And so, as that prostate gland gets bigger, the urethra that passes through it gets narrowed. And when that urethra gets narrowed you have urinary problems.
Trevor: Interesting. Okay. So that would be my question. As gentlemen are aging, what kind of symptoms might they experience if they are dealing with an enlarged prostate?
Dr. Hsu: Yeah, so typical symptoms that my patients have are getting up at night frequently. And what I mean by that is three to five times at night. Obviously, you’re not getting a good night’s rest.
Dr. Hsu: Also, having a very weak stream or interruptive stream when you’re urinating. And then some of our men feel urgency, like they’ve got to go urinate, but when they do it’s only a small amount. Other men feel that when they pee, they’re just not emptying their bladder completely. And at its worst, there are some men who then, all of a sudden, stop peeing altogether, and then they need to have a catheter placed to drain their urine.
Trevor: That is really interesting to know. And I’m sure pretty helpful for people to kind of pinpoint maybe they might be experiencing some of those symptoms. And if they are, what are some of the typical ways of treating enlarged prostate?
Dr. Hsu: Well, you know, simple way is lifestyle changes such as fluid restriction, avoiding alcohol and caffeine. And then also at night, trying to reduce how much fluid you take in.
Obviously, the first line of treatment is always medications. But when medicine fails, or you have side effects that you can’t tolerate from medical therapy, then the next line would be either surgical treatment or non-surgical treatment with prostate artery embolization.
Now, surgical treatment typically involves either removal of the prostate gland or removal of tissue around that urethra in the prostate gland. A lot of minimally invasive surgical therapies involve denuclearization or vaporization of that prostate tissue around that urethra. And UroLift actually tacks up that tissue.
So, I’m here to talk to you about a non-surgical treatment, which is prostate artery embolization.
Trevor: Yeah, and that is so interesting to hear of those various approaches to helping with this issue. But the benefits are probably plentiful, of prostate artery embolization. Tell us a little bit about what makes this a beneficial treatment.
Dr. Hsu: Yes. Happy to.
So prostate artery embolization is something that we only do intravascularly. So, there is no instrumentation in your urinary tract, and thereby there is no risk of incontinence, and no risk of erectile dysfunction as with surgical treatments. And so that is actually very beneficial to a lot of men.
We still preserve fertility. And in fact, 40% of men actually have improved sexual function after prostate artery embolization. This is a nonsurgical treatment that is done as an outpatient. Usually, it only takes a quick recovery of a week and, you know, it’s ideal for really large prostate glands, greater than a hundred grams.
Trevor: Well, it sounds to me like the benefits are plentiful for this artery embolization, for sure. How exactly does the process work?
Dr. Hsu: So, what happens is that an interventional radiology doctor, like myself, we put a small catheter into the groin or the wrist and we navigate that catheter into the prostatic artery.
So, keep in mind that the prostatic artery is actually 16 strands of hair. It’s equivalent to 16 strands of hair. So, it takes a lot of skill to get into that tiny, tiny vessel with microcatheters and wires. But once we have it in, we deploy FDA-approved particle beads that block the blood supply inside that prostate gland and thereby allow it to shrink with time.
Trevor: Wow. That is fascinating. It really is an amazing procedure.
I guess one big question that probably everybody asks, I’m sure is, is there pain involved with this procedure? It sounds like there might not be.
Dr. Hsu: No. I mean, we do these procedures as an outpatient. We do give you sedation so that we keep you nice and comfortable. And after the procedure, most of my patients tell me that they have some mild pelvic discomfort for about a week and then that’s it.
Trevor: That’s great. And I imagine that you’ve probably had rave reviews from some of your patients. Tell me how they feel about this amazing procedure.
Dr. Hsu: So, when we see our patients for follow-up, I think what makes it worthwhile on a very challenging procedure is when they tell me that I’ve made a difference in their life, that you know, this procedure itself has improved their quality of life. And that’s what makes the difference. That’s why it’s worthwhile for us to talk about it during men’s health month.
Trevor: Yeah. Quality of life. I completely agree. I imagine that is an impactful change for the gentlemen out there. And if this sounds like something you, or a family member, or somebody you know or love might be interested in, Dr. Hsu, how can we learn more about prostate artery embolization?
Dr. Hsu: So, you can talk to your urologist who often collaborates with the interventional radiology doctor, who, together, we can find the best treatment for you.
And, also, you can look online at QuitTheDrip.com to get some more information.
Trevor: Excellent. Dr. Hsu, thank you so much for sharing more about this incredible procedure. I learn something new every time ARA is on. We appreciate you taking the time to join us today.
Dr. Hsu: Well, Thanks for talking with me. I really enjoyed it.
Trevor: Thank you. And we’ll see you soon. And friends, we’ll see you soon. Right on the other side of this commercial break. Stay right there. More “We are Austin” is coming right up.
ARA continues to follow CDC guidelines in requiring employees and patients to wear masks at our imaging centers for the safety of all.