{"id":63218,"date":"2022-03-25T10:40:39","date_gmt":"2022-03-25T16:40:39","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=63218"},"modified":"2022-04-08T12:49:11","modified_gmt":"2022-04-08T18:49:11","slug":"prostate-artery-embolization-non-invasive-enlarged-prostate-treatment","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/prostate-artery-embolization-non-invasive-enlarged-prostate-treatment\/","title":{"rendered":"Men sometimes make multiple trips to the bathroom. A minimally invasive treatment for enlarged prostate may help."},"content":{"rendered":"
<\/div>

 <\/p>\n

\"Three
A problem common to older men that may complicate a man’s quality of life is benign prostatic hyperplasia (BPH), or non-cancerous enlargement of the walnut-shaped prostate gland, which sits below the bladder. Now there is a non-invasive treatment option called prostate artery embolization.<\/figcaption><\/figure>\n

In 2003, Dennis McDougal retired after a long and successful career in the railroad industry. He and his wife Candace remained in Denver, where they had happily settled in 1997.<\/p>\n

About the time of his retirement, however, McDougal, now 74, noticed that when he walked, his right arm didn\u2019t swing naturally and in rhythm with his left one. After seeing more than one neurologist, he was eventually diagnosed with Parkinson\u2019s disease. He continues to receive care for the movement disorder at the UCHealth Neurosciences Center \u2013 Anschutz Medical Campus<\/a>.<\/p>\n

But another problem common to older men severely complicated McDougal\u2019s health and quality of life: benign prostatic hyperplasia<\/a> (BPH), or non-cancerous enlargement of the walnut-shaped prostate gland, which sits below the bladder. When the prostate enlarges, it restricts the flow of urine from the bladder to the urethra, the tube through which urine passes out of the body. BPH can make a man have to get up frequently to urinate and with greater difficulty. In severe cases, the blockage causes urinary tract infections. Some patients may have to wear catheters to drain the bladder \u2013 in itself an infection risk.<\/p>\n

Parkinson\u2019s disease complicated by enlarged prostate<\/strong><\/h2>\n

For Dennis McDougal, BPH was a particularly tough problem because his Parkinson\u2019s disease causes tremors and gait and balance problems. He had to get up several times a night to go to the bathroom, which increased his risk of falling and made it very difficult to go anywhere outside his home. He became, in effect, a prisoner to the BPH.<\/p>\n

Urologists can treat BPH by surgically entering the urethra and reducing the size of the prostate with heating, freezing, coring and other techniques, said Dr. George Zlotchenko<\/a>, medical director of Radiology and Interventional Radiology<\/a> at UCHealth Highlands Ranch Hospital<\/a>. McDougal needed treatment of his enlarged prostate, Zlotchenko said, but was looking for a minimally invasive alternative to surgery because of his Parkinson\u2019s disease symptoms, particularly tremors.<\/p>\n

A non-surgical treatment for enlarged prostate<\/strong><\/h2>\n
\"Interventional
Interventional radiologist Dr. George Zlotchenko treats non-cancerous enlarged prostate with a procedure called prostate artery embolization, which shrinks the gland by blocking its blood supply. Photo by UCHealth.<\/figcaption><\/figure>\n

Urologist Dr. David Sobel<\/a> at Highlands Ranch Hospital referred McDougal to Zlotchenko, who offered McDougal a minimally invasive treatment option to consider: prostatic artery embolization (PAE). Surgery pares the enlarged prostate down to size; embolization shrinks it by starving its blood supply. The provider uses a catheter to deliver microscopic particles to the blood vessels that feed the prostate. The particles obstruct, or embolize, blood flow to the enlarged gland, and it gets smaller. It\u2019s an outpatient procedure that is almost completely painless and generally allows patients to go home the same day, Zlotchenko said.<\/p>\n

It\u2019s a tested approach. Interventional radiologists use embolization to shrink non-cancerous uterine fibroid tumors<\/a> the same way they shrink enlarged prostates. Blood flow-blocking particles are also used in genicular artery embolization<\/a> to treat knee pain caused by osteoarthritis, but in that case, the goal is to reduce inflammation rather than shrink tissue.<\/p>\n

To qualify for PAE, patients complete an International Prostate Symptom Score (I-PSS)<\/a> questionnaire that measures the severity of their issues, such as frequency and urgency of urination, as well as the effects of the condition on their quality of life. The higher the score, the greater the symptom severity and likelihood that a patient is a candidate for the procedure, Zlotchenko said.<\/p>\n

Preparation before pursuing prostate artery embolization<\/strong><\/h2>\n

Prior to PAE, Zlotchenko said he performs a CT angiogram to examine the blood vessels for potential challenges, like plaque-stiffened arteries. With the patient anesthetized, he threads a catheter, generally through the radial artery in the wrist, and advances it to the prostatic artery, guided by contrast and 3D imaging. With the catheter properly positioned, he deploys the blood flow-blocking particles. The greatest risk, Zlotchenko said, is \u201cnon-target embolization,\u201d meaning deploying the particles to the wrong area, such as the bladder or rectum, but he added it\u2019s a relatively rare problem that he\u2019s never encountered in the PAEs that he\u2019s performed.<\/p>\n

Zlotchenko said he\u2019s had \u201cexcellent results\u201d from PAE, as measured by comparing patients\u2019 pre-procedure I-PSS scores to their results three months after. He added that it\u2019s possible to repeat the procedure, but so far he hasn\u2019t had to.<\/p>\n

\u201cThe data show it has had pretty durable results,\u201d Zlotchenko said.<\/p>\n

\"Urologist
Urologists Dr. David Sobel and Zlotchenko work together to determine the most appropriate treatment for men with an enlarged prostate, which can be prostate artery embolization. Photo by UCHealth.<\/figcaption><\/figure>\n

He emphasized that PAE can be a primary treatment for BPH as well as an alternative to surgery or medical therapy. He\u2019s part of a treatment team, he added. \u201cI always send patients to a urologist to consult before they make a decision,\u201d he said.<\/p>\n

Not all urinary symptoms are caused by prostate problems, Zlotchenko noted, which also emphasizes the importance of working with a urologist. For example, sometimes problems in the brain, the spine or nerves disrupt control of the bladder. The condition, called neurogenic bladder<\/a>, can cause urinary problems similar to BPH.<\/p>\n

Improved quality of life after successful prostate artery embolization procedure<\/strong><\/h2>\n

Zlotchenko carefully explained the details of the PAE procedure to the McDougals and gave them literature to review. \u201cHe went into great depth,\u201d said Dennis, who decided on PAE and its minimally invasive approach. He had it at UCHealth University of Colorado Hospital on the Anschutz Medical Campus<\/a> in September 2021.<\/p>\n

McDougal\u2019s Parkinson\u2019s disease made his case unusual, and Zlotchenko and his team took extra precautions to address it. For example, McDougal\u2019s tremors had to be well-controlled before Zlotchenko could painstakingly guide the catheter through his blood vessels.<\/p>\n

The strategy included putting McDougal under general anesthesia \u201cto keep him paralyzed,\u201d Zlotchenko said. In addition, \u201cI worked with my anesthesia colleagues to make sure the patient got his medications as close to his scheduled doses as possible.\u201d<\/p>\n

The procedure went well and has helped improve McDougal\u2019s symptoms. He keeps a bedside commode as a precaution but is no longer making multiple and often unproductive trips to the bathroom every night. With that, his fall risk has decreased, which is especially important as his Parkinson\u2019s disease continues to progress.<\/p>\n

He also has a new measure of stability in his daily life. Before the procedure, the problems caused by his enlarged prostate meant that it was nearly impossible for him to go anywhere that he didn\u2019t have constant bathroom access.<\/p>\n

\u201cIt\u2019s given us a much better quality of life, even enabling us to take short walks together,\u201d Candace said.<\/p>\n

Dennis too appreciates the improvements Zlotchenko made possible with PAE. \u201cIt has made a world of difference for the good,\u201d he said.<\/p>\n

To reach Dr. Zlotchenko at the\u00a0TCU Medicine Interventional Radiology – Highlands Ranch Specialty Care Center, <\/a><\/strong>\u00a0call 720.516.3064.<\/p>\n","protected":false},"excerpt":{"rendered":"

  In 2003, Dennis McDougal retired after a long and successful career in the railroad industry. He and his wife Candace remained in Denver, where they had happily settled in 1997. About the time of his retirement, however, McDougal, now 74, noticed that when he walked, his right arm didn\u2019t swing naturally and in rhythm […]<\/p>\n","protected":false},"author":2143,"featured_media":63230,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[4858,351],"class_list":["post-63218","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-interventional-radiology","tag-primary-care"],"acf":[],"yoast_head":"\nProstate artery embolization: non-invasive enlarged prostate treatment - UCHealth Today<\/title>\n<meta name=\"description\" content=\"A non-cancerous enlarged prostate treatment called prostate artery embolization shrinks the gland by blocking its blood supply.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/prostate-artery-embolization-non-invasive-enlarged-prostate-treatment\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Men sometimes make multiple trips to the bathroom. 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