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What is an enlarged prostate or benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH) is the non-cancerous growth of the prostate gland, which is found near the bladder, affecting approximately 50 percent of men in their 50s and as many as 90 percent in their 70s and 80s. With this condition, the total number of cells within the prostate gland increases, either through an increase in cell growth and/or decrease in normal cell death. As the prostate gland grows, it can slow or stop the flow of urine from the bladder–also called bladder outflow obstruction. BPH and bladder outflow obstruction can be categorized as lower urinary tract symptoms (LUTS). Symptoms of LUTS include frequent urination, urgency to urinate, poor urine stream and incomplete emptying of the bladder. BPH may also cause chronic blood in the urine. Diagnosis of BPH includes a detailed exam to rule out other possible causes of LUTS, as well as laboratory tests.

Symptoms

  • Enlarged prostate
  • Difficulty urinating
  • Weak urinary stream
  • Nocturia
  • Waking up at night to urinate
  • Inability to urinate
  • Difficulty emptying bladder
  • Frequent urination
  • Blood in urine
  • Blood from prostate

Treatment Information

Prostatic artery embolization

Prostatic artery embolization is a new approach for the treatment of lower urinary tract symptoms. Through image guidance, an interventional radiologist makes a tiny incision in either the groin or the wrist to insert a catheter into an artery and directs the small tube to blood vessels of the prostate. Once there, the interventional radiologist blocks the blood flow to specific areas of the prostate, depriving those prostate cells of oxygen and resulting in shrinkage of the prostate gland.

Patients who undergo PAE have reported high satisfaction, no urinary incontinence, or sexual side effects. The only external sign that they underwent treatment is a small puncture mark on the groin or wrist. Minor side effects include frequent and/or difficult urination, pelvic pain, blood in the urine, blood in the stool and diarrhea. Most of these side effects resolve on their own within a short time period.

SIR Position Statement on PAE

The Society of Interventional Radiology’s position statement on PAE for BPH notes that PAE, a novel and promising therapy, appears safe and efficacious based on short-term follow-up. Patient satisfaction is high, and repeat intervention rates are low. The PAE procedure is technically challenging, with a possibility of complications if it is not performed meticulously. Interventional radiologists, given their knowledge of arterial anatomy, experience with microcatheter techniques, and expertise in other embolization procedures, are the specialists best suited for the performance of PAE.

Background Information

While there are many other treatments for benign prostatic hyperplasia, interventional radiologists provide individuals suffering from BPH an innovative treatment called prostatic artery embolization (PAE), a minimally invasive treatment that has less risk, less pain and less recovery time than traditional surgery and that does not carry the risk of sexual side effects typically associated with invasive surgeries.

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Dr. Adam Farkas

We believe in partnering with you, in order to alleviate your suffering. Our patients’ concerns are our concerns, and we take pride not only in providing excellent outcomes to our patients, but in seeing a smile on their faces.

National referral center for complex vascular disorders

with 3000 annual procedures performed

Condition FAQ

Please call 02-564-5634 and ask for an appointment in Dr. Farkas’s private clinic in Jerusalem. As part of your evaluation for BPH, you will also need to be evaluated by a urologist in order to become aware of other treatment options for BPH such as surgery, and to assess for other potential causes of urinary problems such as overactive bladder or prostate cancer.

Once you are seen in Dr. Farkas’s clinic and are determined to be a candidate for the “embolization” procedure, the procedure will be scheduled with our scheduling coordinator. Typically an appointment can be given within a few weeks time. We will make every effort to assist in having your procedure covered by kuppat cholim. You will have the option of doing the procedure via “sharap” which allows you to guarantee that Dr. Farkas (and not another physician in the department) performs your procedure. Doing the procedure via “sharap” is generally covered by private insurance and involves a co-payment if done via kuppat cholim. Our scheduling coordinator at 02-655-5014 will be happy to explain the details.

You can expect to have your procedure performed in the morning of your appointed date. The procedure typically takes about 2 hours, during which you will be partially sedated (partially asleep). You will then go home several hours after the procedure, typically in the late afternoon/evening time. You can expect to return to your normal activities within 1-2 days.

No! The PAE procedure is performed by inserting a tiny catheter into a blood vessel in the wrist or the upper leg. It is then navigated to the blood vessels of the prostate and used to close off those blood vessels. One of the advantages of PAE over other options is that the procedure is not performed by inserting instruments through the penis.

You will be asked to follow up in Dr. Farkas’s clinic several months after your procedure. If relief of your urinary symptoms is insufficient, we will be happy to discuss further treatment options.

More Resources

Benign Prostatic Hyperplasia – Society Interventional Radiology

Benign Prostatic Hyperplasia - Radiologyinfo

Prostate Artery Embolization – Video

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