You Don’t Have to Live Your Life Around the Nearest Restroom
If you’re a man over 50, chances are your prostate has already started to grow; and chances are, no one has told you how many ways there are to treat it. An enlarged prostate is one of the most common conditions men face as they age, yet many men quietly rearrange their lives around it: mapping every restroom on a road trip, getting up two or three times a night, or simply accepting a weak, hesitant stream as “part of getting older.” It doesn’t have to be that way. The symptoms are common; they are treatable, and today there are more options than most men realize, including a minimally invasive procedure that relieves symptoms while preserving sexual function.
An enlarged prostate is called benign prostatic hyperplasia, or BPH. As the gland grows, it can press on the urethra, the tube that carries urine out of the body, and produce what’s called lower urinary tract symptoms: frequency, urgency, a slow or interrupted stream, the feeling of not emptying completely, and those middle-of-the-night trips to the bathroom. Left unaddressed, more severe cases can lead to recurrent infections, bleeding, or an inability to urinate at all.
The good news is that treatment follows a sensible ladder. For milder symptoms, lifestyle adjustments and medications help many men a great deal. When those aren’t enough, or when the side effects aren’t worth it, procedures come into the conversation. This is where many men get stuck. Some are afraid of surgery. Others worry, understandably, about the effect an operation might have on their sexual function. So, they wait, and they suffer, when they don’t need to.
As an interventional radiologist, I offer one of those options: prostate artery embolization, or PAE. Rather than removing or cutting prostate tissue, PAE works from the inside of your blood vessels. Through a pinhole in the groin, I thread a catheter, thinner than a strand of spaghetti, and use live X-ray imaging to guide it to the tiny arteries that feed the prostate. There, I release microscopic particles that block the blood supply. Starved of that blood flow, the prostate gradually shrinks over the following weeks, easing the pressure on the urethra so urine can flow more freely.
Many of my patients are often surprised at how manageable the experience can be. PAE is an outpatient procedure done under local anesthesia with light sedation — you stay awake and comfortable, and general anesthesia isn’t needed. There’s no surgical incision, and most men don’t require a urinary catheter afterward. Most go home the same day and return to their normal routine within a few days, with any soreness handled by over-the-counter medication. Symptoms typically begin to improve over the first several weeks.
The feature men ask about most is sexual function. Here, PAE has a real advantage. Because it doesn’t cut or resect any prostate tissue, it carries a low risk of the sexual side effects that can accompany traditional surgery. That makes it worth discussing for men with very large prostates, for those who’ve had bleeding or difficulty urinating, for men who prefer to avoid an operation, and for those who aren’t good candidates for surgery in the first place.
You should understand, though: PAE may not be right for everyone. Standard surgical treatments can offer faster or more complete relief for some men, and PAE is more likely than surgery to need a repeat procedure down the road. National urology and interventional radiology guidelines now recognize PAE as a legitimate option, but the right choice depends on your prostate, your symptoms, your health, and your goals. That’s why I work alongside urologists, and the best decisions here are made together, after a proper evaluation. It’s also worth remembering that PAE treats a benign, enlarged prostate; it is not a treatment for prostate cancer, so routine screening still matters.
The bottom line is simple. An enlarged prostate is common, but living miserably with it is not necessary. If your symptoms are affecting your sleep, your confidence, or your quality of life, the most important step is the first one: talk to a professional and find out what your options really are.
David P. Fang, MD, Memphis Vascular Center, sees patients at 6401 Poplar Ave, Suite 505, Memphis, TN 38119. For appointments or a consultation, call 901.683.1890.
By David P. Fang, MD
