July 5, 2018

How to Treat an Enlarged Prostate

Transcript

Anchor: Welcome back to We Are Austin. An enlarged prostate is something that many, if not most, men will eventually deal with. Unfortunately, it can cause extreme discomfort. Dr. Michael Nguyen (pronounced “Win”) is here from ARA with what you need to know about men’s health, a very important issue. Good morning, it’s great to see you.

Doctor Nguyen: Thank you so much. Appreciate you having me.

Anchor: This is an important issue. Let’s just dive right in and talk about the prostate enlargement and what’s involved here.

Doctor Nguyen: Sure. Prostate enlargement creates symptoms that are collectively called lower urinary tract symptoms. They are related to an enlarged prostate which is typically a walnut-sized organ located at the base of the penis. We have a picture here showing the prostate and the bladder’s above it. The prostate surrounds the urethra, which is an opening tube channel that is connected to the bladder. It allows the bladder to empty and it also carries semen that is produced. As that prostate enlarges, it squeezes the urethra. So, you can imagine, that prevents flow of the bladder and prevents men from urinating easily.

Anchor: Yeah, absolutely.

Doctor Nguyen: What typically happens is men have difficulty urinating and they’ll sometimes have to strain to urinate. They sometimes have hesitancy where they feel like their stream is stopping and going. Since they can’t fully empty their bladder, they may have to go to the bathroom quite often. Some men talk about having to go to the bathroom four to five times during the day and another four to five times at night. So they can’t fully sleep or feel fully rested. Since the bladder isn’t fully empty, it increases the chance for UTIs—a urinary tract infection. Sometimes they even have incontinence or dribbling because the bladder’s so full, so there’s a lot of discomfort.

Anchor: Those are some quality of life issues for sure.

Doctor Nguyen: Yes, definitely reduces the quality of life. It will occur in almost all men. Fifty percent or more men over 60 will have symptoms.

Anchor: Wow!

Doctor Nguyen: Ninety percent or more of men over 85 years will have symptoms as well.

Anchor: That’s a surprising statistic there. What are some of the typical ways of treating an enlarged prostate?

Doctor Nguyen: Patients can certainly start with simple life-style changes. They can decrease their consumption of fluids and liquids. They can decrease their consumption of alcohol and caffeine which can stimulate urination especially at night before they go to sleep. Unfortunately, that’s typically not enough. They may progress to medications. There are some medications that help to relax the prostate. These are called alpha blockers. There are medications that help shrink the prostate a bit. Those are called 5-alpha reductase inhibitors. So, those are effective. Again sometimes patients progress despite those medications.

Anchor: Oh, I see.

Doctor Nguyen: When that occurs, there are certainly some urological procedures or urological surgeries that can be performed. There are many of them, but the one I’m going to talk about real quick in some patients is traditionally a medical procedure that’s called Transurethral Prostate Resection (TURP) that’s performed. It’s effective, but the way that’s performed is it cores out part of the prostate and there are certain unfavorable side-effects, sexual dysfunction, incontinence, and bleeding. What I wanted to introduce is an alternative procedure – a minimally invasive option for patients.

Anchor: That’s great, yeah!

Doctor Nguyen: Yeah. So, this procedure is called Prostate Artery Embolization. Again, it’s a minimally invasive procedure. It has a relatively low side-effect profile – lack of sexual dysfunction, lack of urinary incontinence. Some patients even describe improved sexual function afterwards.

Anchor: Oh wow! Nice.

Doctor Nguyen: The way we perform the procedure is we make a tiny incision into either the groin—I think there’s a slide here showing the groin. Yeah, so here’s the groin and there’s a blood vessel going into the groin. We can actually make a tiny incision about the width of my pinky or smaller inside the groin or even at the wrist, potentially.

Anchor: I see.

Doctor Nguyen: Basically advance a catheter which is a tiny tube down to the vessels that supply the prostate.

Anchor: Ok.

Doctor Nguyen: Here is the prostate and here are the vessels that carry the blood supply to it. So, once we actually get into those blood vessels that supply the prostate, we can infuse tiny little particles.

Anchor: Oh, wow.

Doctor Nguyen: These particles basically block up the blood supply to the prostate. There’s no severe detriment to the prostate, but what it does is help the prostate to shrink a bit in size and relieve the blockage. Here, both sides of the prostate and vessels are embolized and again this helps the prostate shrink a bit and helps to relieve the pressure on the urethra, therefore patients can urinate more freely.

Anchor: I bet that’s a relief, yeah.

Doctor Nguyen: It’s very, very effective. Keep in mind that this procedure, while being slowly adopted in the US, has been performed for ten years or more outside of the US and has been very effective. Literature is showing that it’s ninety percent effective or more when technically successful. It’s a great option. What I really want to do is just make sure patients are aware of it.

Anchor: Yes.

Doctor Nguyen: We definitely do want to work in conjunction with their urologist to figure out what’s the best procedure or option. It may be Prostate Artery Embolization, it may be a urological surgery. You know, I just want them to know there’s definitely other options out there.

Anchor: Options! I think that’s really important and I think that’s what you all do very well at ARA. This is an option right here. There is a special line actually that they can call if they have prostate issues and are wanting to know a little bit more, correct?

Doctor Nguyen: Right. We have direct lines to our clinical team there; the Interventional Radiology team. They can certainly give them a call directly and get ahold of us and we will certainly work with them. They can also be referred through their primary doctor or their urologist. Again, our goal is to work in conjunction with those other doctors and figure out what’s best for them.

Anchor: Well it seems like a really great option and I am really happy to have you here today to let our audience know that there are options out there.

Doctor Nguyen: Thank you.

Anchor: Thank you so much for joining us, we appreciate it

Doctor Nguyen: Thank you so much.

Anchor: Check them out at ausrad.com to check out more about this wonderful procedure.