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Can prostate shrink without surgery?

hopkinsmedicine.org - Nonsurgical Treatment for Benign Prostatic Hyperplasia

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If you’re a man over 50, you have a one in three chance of having benign prostatic hyperplasia (BPH), the most common benign tumor found in men. BPH causes symptoms such as lack of bladder control, increased urinary frequency, and urgency and pain. For those with minor symptoms, medication or diet changes can help, but as symptoms increase, surgery is often the next step. But for men who are not candidates for surgery, or have a strong desire to avoid surgery, prostatic artery embolization (PAE) is a new treatment option. Interventional radiologist Brian Holly, M.D. , explains what you should know about the prostatic artery embolization procedure and if it may be right for you.

What is PAE?

PAE is a nonsurgical procedure that decreases the blood supply to the prostate, thus reducing its size and symptoms. An interventional radiologist, who uses X-rays and other imaging techniques to see inside the body and treat conditions without surgery, performs PAE. At Johns Hopkins, our interventional radiologists are expertly trained and experienced in performing this technically challenging procedure.

Who is eligible for PAE?

The PAE procedure is best for candidates who are either ineligible due to pre-existing health conditions or not interested in traditional surgery. An exam with an interventional radiologist can determine if you are a candidate for PAE. At this appointment, you may be asked how often you have urinary symptoms of BPH, how severe they are, and how much they affect your quality of life. Men who have advanced heart diseases associated with smoking or diabetes may not be candidates for PAE.

What are the benefits to PAE?

PAE is less invasive then other procedures so patients can return to their normal lives sooner. The PAE procedure can also have a lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction), when compared with more invasive surgical procedures such as a TransUrethral Resection of the Prostate (TURP).

How effective is PAE?

PAE is a new and promising procedure. In a study published in 2016, 630 patients underwent a prostate artery embolization procedure. The study found that the procedure had a positive effect on urinary symptoms as well as overall quality of life. This positive effect lasted 1-3 years in 82% of the patients and lasted 3-7 years in 76% of the patients. Additionally, there was no urinary incontinence or sexual dysfunction reported. With the high success rate of PAE, men ineligible for surgery are able improve their quality of life by eliminating or reducing uncomfortable BPH symptoms. Be sure to speak to your urologist to help determine the best approach for you.

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Do they still check your prostate with a finger?

Because the prostate is an internal organ, your doctor cannot look at it directly. But because the prostate lies in front of the rectum, they can feel it by inserting a gloved, lubricated finger into the rectum. It may be performed in the screening of prostate cancer.

webmd.com - Digital Rectal Exam (DRE) for Prostate Cancer - WebMD

Doctors use the digital rectal exam (DRE) as a relatively simple test to check the prostate. Because the prostate is an internal organ, your doctor cannot look at it directly. But because the prostate lies in front of the rectum, they can feel it by inserting a gloved, lubricated finger into the rectum. It may be performed in the screening of prostate cancer. Who Should Get a Digital Rectal Exam? Not all medical institutions agree on when men should begin screening (routine testing) for prostate cancer or even if a DRE should be part of the screening. To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested. For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer -- African-American men or men with a family history of prostate cancer -- start screening earlier. What Happens During a Digital Rectal Exam? Your health care provider will insert a gloved finger into the rectum and feel the prostate for hard, lumpy, or abnormal areas. The test takes only a few minutes to complete. You may feel slight, momentary discomfort during the test. The procedure does not cause significant pain or any damage to the prostate.

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