Latest approved treatment for lower urinary tract symptoms caused by enlarged prostate

In around a third of men lower urinary tract symptoms (LUTS) are caused by an enlarged prostate. Having an enlarged prostate, is a condition which is also known as Benign Prostate Hypertrophy (BPH). A new procedure known as prostate artery embolisation (PAE), developed by pioneering interventional radiologist Dr Nigel Hacking is now providing an excellent minimally invasive approved option for treating the symptoms of LUTS. The high success rate with minimal side-effects is very good news for men suffering from lower urinary tract symptoms (LUTS) caused by an enlarged prostate.

These unfortunate prostate related lower urinary tract symptoms can often include the following:

  • Hesitancy obstruction during urination,
  • Intermittent urine stream,
  • Straining to urinate,
  • Prolonged and unplanned urine excretion,
  • Feeling of incomplete bladder emptying,
  • Urine dribbling and
  • Increased frequency and urgency with trips to the bathroom at night (nocturia)

There are various traditional treatment options and the first line is usually medical - involving drugs. There are also various forms of surgery that all have various risk and outcome profiles. However, men are increasingly seeking non-surgical procedures that reduce risk to normal urinary and sexual functions, and are proving to be highly effective. One such procedure that my well become the treatment option of choice for most men is prostate artery embolisation (PAE), and PAE has now been NICE approved. The straightforward day case procedure involves blocking the blood vessels supplying the prostate with tiny plastic particles. As a result the prostate shrivels and is then naturally re-absorbed by the body without any need for surgery.

The UK pioneer for PAE is Dr Nigel Hacking and video of what is involved in the PAE procedure can be seen on the BBC. As an interventional radiologist, Dr Hacking is one of the most technologically advanced type of specialist doctor. In Dr Hacking's article Treating enlarged prostate (BPH) by prostate artery embolisation, he says, "The process by which the prostate begins enlarging starts around the age of 30 and up to 50% of men will show histological signs (changes within the tissues) of BPH by 50 years of age. By 80 years of age this rises to 75% although not all of these men will have symptoms. Symptomatic BPH occurs in up to 50% of men of middle age or older."

Dr Nigel Hacking, Clinical Lead for UK-ROPE talks to Laura Trant for BBC on PAE.

The big news for most men is that in his article, Treating benign prostatic hyperplasia by PAE  Dr Hacking says, "As in all published PAE studies to date symptomatic improvement was seen in just over 80% of men at 3-12 months, and these improvements were sustained at medium and long term follow-up with cumulative success rate of 78%."

Symptomatic improvement seen in over 80% of men

A blood vessel that carries blood away from the heart. Apart from the pulmonary artery and umbilical artery, all arteries carry oxygenated blood. Full medical glossary
Not dangerous, usually applied to a tumour that is not malignant. Full medical glossary
Enlargement of the prostate, which may cause difficulty in passing urine. Full medical glossary
The organ that stores urine. Full medical glossary
A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
blood pressure Full medical glossary
An abbreviation for benign prostatic hyperplasia, which is enlargement of the prostate that may cause difficulty in passing urine. Full medical glossary
The basic unit of all living organisms. Full medical glossary
intermittent claudication Full medical glossary
Needing to get up to urinate at night. Full medical glossary
pulmonary embolism Full medical glossary
A gland that surrounds the urethra near the bladder. It produces a fluid that forms part of the semen. Full medical glossary
A doctor specializing in the interpretation of imaging techniques for the diagnosis and assessment of disease. Full medical glossary
A group of cells with a similar structure and a specialised function. Full medical glossary
The channels that carry urine from the kidneys to the outside of the body. Full medical glossary
The passing of urine from the body. Full medical glossary