Can prostate size be reduced 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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Is there a prostate pill that works?

Tamsulosin belongs to a group of medicines called alpha-blockers. It's used to treat men with symptoms of an enlarged prostate (benign prostate enlargement). It's also occasionally taken to treat kidney stones. Tamsulosin is available on prescription and you can also buy it from pharmacies.

nhs.uk - Tamsulosin: a medicine used to treat men with symptoms of an ... - NHS

Tamsulosin comes as slow-release tablets and capsules (also called modified release, prolonged release, MR or XL).

This means the medicine is released into your body gradually.

How much will I take?

The usual dose of tamsulosin for enlarged prostate and kidney stone is 400 micrograms, once a day. The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg). A microgram is 1,000 times smaller than a milligram (mg).

How to take it

Swallow your tamsulosin capsules or tablets whole with a glass of water.

Do not break, chew or crush them.

If you can, take tamsulosin in the morning, after breakfast or the first meal or snack of the day. This is so the highest levels of medicine are in your body during the day and gives you the most benefit when you are most likely trying to pee.

It's best to take it at about the same time each day.

What if I forget to take it?

If you miss a dose of tamsulosin, and you remember within 6 hours, take the missed dose as soon as you remember. If it's more than 6 hours, skip the missed dose and take your next dose at the usual time the next day. Do not take a double dose to make up for a forgotten dose. If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking too much tamsulosin can lead to a decrease in your blood pressure and an increase in your heart rate. You may feel drowsy, faint and lightheaded.

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