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Walk the walk this #Movember & talk about PAE

02 November 2018

It’s an unfortunate fact – men don’t talk about the things that trouble them, whether it be their mental or physical health. When a problem is acknowledged it can be hard for men to take the first step, to find support and help. But the #Movember movement is hoping to change that by raising awareness and highlighting the health issues that result in unnecessary suffering and, sadly, premature death in men across the UK. By growing a moustache and ‘walking the walk’, it’s hoped that life-saving conversations can be started.

One of the subjects men are being encouraged to talk about is prostate health. Here at Spire Dunedin Hospital, Reading, we are leading the way in the treatment of prostate issues by offering Prostate Artery Embolization or PAE - this is a minimally invasive treatment for benign prostatic hyperplasia (BPH) a non-cancerous enlargement of the prostate.

Consultant Interventional Radiologist Dr Mark Little performs the treatment. As one of the first radiologists in the UK to perform PAE, Dr Little gained grant funding from the Royal College of Radiologists to start the first prospective research study in the UK investigating PAE. He is now one of the most experienced Interventional Radiologists in the UK carrying out PAE and regularly mentors other consultants on the procedure, as well as lecturing on PAE globally.

PAE was first carried out as a treatment for symptomatic benign prostatic hyperplasia in 2000. Since then it has been the subject of clinical research and has attracted interest as a treatment option for men with enlarged, symptomatic prostates, with no evidence of malignancy, who would like to avoid conventional surgery.

BPH is one of the most common medical complaints experienced by older men – 50% of men over the age of 50 suffer from it - and, up until April 2018, the standard treatment was either long term medication or surgery. Though these treatments do work, there can be associated side effects, such as bleeding, incontinence and impotence. PAE is now a NICE approved minimally invasive treatment for reducing the distressing problems caused by benign prostate enlargement.

The procedure is performed by Dr Mark Little through a tiny “pin-hole” incision in the wrist or groin. X-ray (fluoroscopy) is used as a roadmap to guide a fine plastic tube (catheter) into the small prostate arteries. Tiny particles, similar to fine grains of sand, are injected into the prostate arteries to block the blood supply to the prostate gland, which will subsequently shrink the gland over a period of time, alleviating pressure on the bladder and urethra.

The procedure is performed under local anaesthetic, avoiding the need for a general or spinal anaesthetic, enhancing the speed of the recovery process. There is a significant reduction in hospital stay with research trial results showing that over 70% of PAE cases were performed as a same-day discharge[1]

After PAE, 18% of patients reported a degree of hematuria (the presence of red blood cells in the urine), which was less than after TURP (64%). Hematospermia (blood in the semen) was reported in 12.6%, and patients should be aware of this possible issue after PAE. It is however, a particularly good option for those worried about maintaining sexual function.

Results from research trials show PAE to be very effective at reducing patient symptom scores, and it is being used more and more in gentleman with urinary catheters as a consequence of BPH; at two weeks following PAE over 85% of patients can expect successful catheter removal. Due to the good safety profile of PAE, it is worth considering in men who want to avoid - it is an effective and appropriate treatment for men who would like to avoid surgery and the risks of a general anaesthetic.

It should be noted that not all men with BPH will be suitable for PAE and it is essential that patients are properly assessed by a Consultant Interventional Radiologist and Consultant Urologist, as part of a multi-disciplinary team, to establish the correct treatment package for the individual gentleman. Being a minimally invasive treatment for BPH with rapid recovery time, PAE is an attractive option!

So this #Movember don’t live with an uncomfortable prostate - get talking. At Spire Dunedin Hospital we provide fast access to diagnosis and it’s often possible to get a consultation within 48 hours. We offer 0% finance which our self-pay team can talk you through should you wish to explore this option.

 

[1] https://onlinelibrary.wiley.com/doi/abs/10.1111/bju.14249

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