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Enlarged Prostate Treatment: What Are Your Options?

Sleep interrupted by trips to the bathroom, sudden urges to urinate while working in the yard (or while enjoying a family dinner) and an inability to empty your bladder — these are some of the ways an enlarged prostate, also called benign prostatic hyperplasia, or BPH, can throw your life out of rhythm. Still, minimally invasive treatment for an enlarged prostate can help restore your confidence and peace of mind.

The prostate is a gland surrounding the urethra (the tube that carries urine out of the bladder), and it grows as you age. This growth affects the urethra and bladder, causing urinary symptoms. Your chances of developing an enlarged prostate increase after age 40, and your risk increases as you get older.

About half of men ages 51 to 60 have an enlarged prostate, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it’s even more common in older men. But that doesn’t mean they have to put up with the symptoms.

Enlarged Prostate 101

Those symptoms occur in part because as the prostate gland grows, it presses against the urethra. As a result, some urine may remain in the bladder after urinating, which is known as urinary retention.

It isn’t clear why many men develop an enlarged prostate gland. However, some causes may include genetics/hereditary reasons, changes in the body’s testosterone-to-estrogen ratio that occur with age, and increased levels of the hormone dihydrotestosterone contributing to prostate growth.

An enlarged prostate does not increase your risk for prostate cancer. It can, however, cause a variety of disruptive or uncomfortable lower urinary tract symptoms, including:

  • Blood in the urine
  • Difficulty initiating a urine stream
  • Dribbling
  • Inability to empty your bladder completely
  • Incontinence
  • Urinary frequency
  • Nocturia (Needing to urinate multiple times during the night)
  • Sudden urge to urinate
  • Weak urine stream

Tell your primary care provider if you experience enlarged prostate symptoms. It’s important not to ignore your symptoms because, in some cases, an enlarged prostate can lead to complete urinary retention requiring urinary catheter placement, bladder stones, urinary tract infections or other complications.

Your provider may perform a physical exam, order radiology/imaging scans, and order urine tests to evaluate the urinary tract and prostate gland. If an enlarged prostate is causing your symptoms, treatment can begin.

Enlarged Prostate Treatment: Lifestyle Modifications and Medication

There are many treatment options to help alleviate bothersome urinary symptoms caused by an enlarged prostate gland. Treatment plans are based on each individual’s needs and symptoms.

If your symptoms don’t bother you, you may just need to see your medical provider regularly so they can check if the symptoms are worsening. For mild symptoms that interfere with your daily life, lifestyle modification changes may help, including:

  • Minimizing medications such as decongestants or antihistamines
  • Drinking fluids consistently during the daytime, instead of large intermittent quantities in the evening
  • Exercising regularly to keep symptoms from worsening due to inactivity.
  • Reducing alcohol and caffeine intake
  • Bladder training, which can help adapt to holding more urine longer
  • Reducing fluid intake before important daytime activities and two hours before bedtime

Certain medications can also help provide relief from lower urinary tract symptoms. Medications called alpha-blockers, for example, can help you urinate by relaxing the muscles around the urethra and bladder neck. Another type of medication called 5-alpha reductase inhibitors can limit prostate growth by decreasing dihydrotestosterone production. Like most medications, the ones used to manage lower urinary tract symptoms and BPH can cause side effects. Discuss these with your provider to find the most appropriate medication for you.

Minimally Invasive Procedures for Enlarged Prostate Treatment

There are multiple different minimally invasive treatment options for an enlarged prostate gland. One of those procedures is called prostatic artery embolization (PAE).

PAE is an outpatient minimally invasive procedure treated through a tiny hole in the wrist or groin. With advanced imaging guidance, an interventional radiologist makes a small puncture in the arm or groin and navigates a catheter through the arteries down to the prostate. Once the catheter reaches the main artery supplying the prostate gland, the interventional radiologist can inject different types of material into the blood vessels to block the blood flow into the prostate gland. As a result, the gland shrinks slowly over time, alleviating symptoms. Compared to surgical options for BPH, the minimally invasive PAE procedure offers fewer post-procedure complications and shorter recovery times.

PAE is one of several minimally invasive procedures to treat prostate enlargement. Talk to your urologist or interventional radiologist about the symptoms you are experiencing to determine the best treatment option for you.

Your Partner for Symptom Relief Without Surgery

At Vascular & Interventional Specialists, a division of Charlotte Radiology, our board-certified interventional radiologists use sophisticated technologies and leading-edge procedures to help unlock better lives for our patients. That’s why so many men trust us for enlarged prostate treatment. If you’re looking for an alternative to surgery, we’re ready to help you explore whether PAE can help you with your symptoms.

Curious about PAE? Request an appointment with an interventional radiologist.