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New Surgery-Free Treatment for Enlarged Prostate Avoids Sexual Dysfunction

Prostatic artery embolization as effective as popular TURP surgical method; more than half of senior men have enlarged prostate; also silodosin a new treatment for prostatitis

May 18, 2011 - A new radiology treatment that limits blood flowing to a man’s enlarged prostate gland – an ailment impacting over half of male senior citizens - appears to be as effective as today’s most popular treatment, but without the risks, such as sexual dysfunction, urinary incontinence, blood loss and retrograde ejaculation, noted researchers at the Society of Interventional Radiology's 36th Annual Scientific Meeting in Chicago last month.


Related Archive Stories


Rising PSA Levels May Sometimes Lead to Negative Biopsies But Usually Means Cancer

News study shows nearly 70 percent with rising PSA eventually get prostate cancer

May 18, 2011

Avodart Not Cost Effective Way to Prevent Prostate Cancer in Some Men

For average man, dutasteride provides minimal survival benefits, reduction on treatment-related complications does not offset the high costs

Feb. 8, 2011

Study Finds Way to ID Aggressive Prostate Cancers; Save Men from Aggressive Therapy

Many prostate cancer patients treated unnecessarily; vast majority would not become life-threatening, even if left untreated

Feb. 3, 2011

Incontinence Following Radical Prostatectomy Reduced by Behavioral Therapy Program

Editorial writers ask if limited benefits are worth the patient and clinician time and effort; researchers say 'yes' do to significant, durable improvement in incontinence and quality of life, - Jan. 12, 2011

Substantial Improvement in Prostate Cancer PSA Testing Discovered by Genetics Firm

Better results will prevent unnecessary biopsies, catch more cancers, says deCODE

Dec. 16, 2010

Popular Prostate Cancer Staging Does Not Predict Recurrence, Study Finds

Clinical stage was assigned incorrectly in 35.4% of 3,875 men in a multi-institutional national disease registry - Nov. 22, 2010

Aspirin Cuts Death Risk in Half for Prostate Cancer Victims Using Radiation or Surgery

Prior studies have shown anticoagulants like aspirin hinder cancer growth,spread

Oct. 25, 2010

Cholesterol-Lowering Drug Shrinks Enlarged Prostates in Hamsters: Hope for Older Men

Even more effective when combined with drugs approved for treating BPH - watch videos

Oct. 22, 2010 –  Read more, watch videos...

Even Senior Citizens Can Reduce Cancer Risk with Plant-Based Diet, Exercise Says New Study

‘It’s Never Too Late to Lower Your Risk’ is new campaign by American Institute for Cancer Research (see video)

Oct. 21, 2010

More Links to Archived Reports at Bottom of this Page


Read the latest news
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"Benign prostatic hyperplasia or BPH is so common that it's been said that all men will have an enlarged prostate if they live long enough, said João Martins Pisco, M.D., chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal.

“I believe that a minimally invasive interventional radiology treatment—prostatic artery embolization or PAE—will be the future treatment for benign prostatic hyperplasia or men's noncancerous enlarged prostates."

Today’s most used therapy is surgical transurethral resection of the prostate (or TURP).

"While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical results—without TURP's limitations and risks," said Pisco.

The interventional radiologist indicated that PAE patients experienced symptom improvement comparable to TURP; however, certain urodynamic results (such as flow rate of the urinary stream) did not improve as much as with TURP.

Experimental Treatment Offers Relief from Painful Prostatitis

Silodosin already used to treat pain from enlarged prostate

May 18, 2011 - New findings show that treatment with a specific alpha blocker helps reduce symptoms and improve quality of life for men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

The alpha-blocker, known as silodosin, works by selectively relaxing the muscles in the bladder neck and prostate. The treatment is already approved in Canada, the United States, the EU and Japan to treat painful symptoms of another prostate gland condition, benign prostatic hyperplasia, commonly referred to as an enlarged prostate.

Despite being the most common form of prostatitis, CP/CPPS is the most misunderstood and difficult to treat because the symptoms are very similar to other conditions and requires a significant degree of testing and screening to identify.

"Antibiotics are commonly used as a treatment, but are not typically effective, probably because CP/CPPS does not seem to be caused by a bacterial infection," explains lead researcher Curtis Nickel, a professor in the Department of Urology, practicing urologist at Kingston General Hospital, and Canada Research Chair in Urologic Pain and Inflammation.

CP/CPPS is a debilitating condition characterized by persistent discomfort in the lower pelvic area including the bladder area, testicles, and penis. Symptoms can be severe and include painful and frequent urination and difficult or painful ejaculation. The cause of the condition is unknown.

In Dr. Nickel's study, approximately 60 per cent of men reported feeling better after treatment with silodosin versus 30 per cent of participants who were given a placebo.

The number of patients who reported feeling better is higher than in a similar study he ran several years ago that tested the effects of a different alpha blocker.

Dr. Nickel, along with his Prostatitis Research Group at Kingston General Hospital and Queen's University, has been studying CP/CPPS for the past two decades. He has been the principal investigator of over a dozen international clinical trials evaluating therapies for chronic prostatitis. His research studies are supported by the Canadian Institute of Health Research, US National Institutes of Health and industry, including Watson Pharmaceuticals who provided the support for this particular clinical trial.

Dr. Nickel presented his results yesterday at the American Urological Association annual meeting in Washington DC. The study results will appear in an upcoming issue of the Journal of Urology.

TURP can be performed only on prostates smaller than 60 cubic centimeters (cc); there is no size limitation for PAE treatment, said Pisco, who is also a professor at the Faculty of Medical Sciences, New University of Lisbon.

"The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms," he added.

"Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anesthesia," said Pisco.

What is BPH?

BPH is not cancer; it is a condition that affects a man's prostate, a gland found between the bladder and the urethra. As a man ages, the prostate gland slowly grows bigger (or enlarges) and may press on the urethra and cause the flow of urine to be slower and less forceful.

BPH is characterized by urinary frequency, urgency, passing urine more often (particularly at night), weakened stream and incomplete bladder emptying.

"Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment," said Pisco. "We need innovative technologies, such as prostatic artery embolization, to continue to improve outcomes and minimize patient discomfort and morbidity when managing enlarged prostates," he added.

An estimated 19 million men in this country have symptomatic BPH, (14 million undiagnosed; 2 million diagnosed but untreated). Statistics show that a small amount of prostate enlargement is present in many men over age 40, as many as 50 percent experience symptoms of an enlarged prostate by age 60 and more than 90 percent of men over the age of 85 will report symptoms.

In this study, 84 men (ranging in ages from 52 to 85) with symptomatic BPH underwent prostatic artery embolization after failing other medical treatments for at least six months.

The men were followed for more than nine months (on average), and PAE was found to be technically successful in 98.5 percent of the patients—with 77 men showing "excellent" improvement, six men "slight improvement" (but needing no medications) and one experiencing no improvement (due to receiving an incomplete embolization), Pisco added.

Two hours after PAE, most men were passing urine less frequently. It was impossible to embolize both prostate arteries in the men showing "slight improvement" due to advanced atherosclerosis, said Pisco.

How the procedure is performed

Prostatic artery embolization is performed by an interventional radiologist, a physician who is trained to perform this and other types of embolization and minimally invasive procedures. An interventional radiologist makes a tiny nick in the skin in the groin and inserts a micro catheter into the femoral artery.

Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, the size of grains of sand, into the prostatic arteries that supply blood to the tumor. These tiny particles block blood flow to the tumor, causing it to shrink. Following PAE treatment, most men experience no pain to light pain and leave the hospital four to eight hours after intervention.

"There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure," added Pisco.

How TURP is performed

BPH can be treated by TURP, a procedure in which a scope is inserted through the penis and the prostate is removed piece by piece, or surgery through an abdomen incision (prostatectomy). During surgery, a man generally undergoes general anesthesia and needs to spend several days in a hospital. Major complications are frequent, such as blood loss, severe pain, sexual dysfunction, impotence, retrograde ejaculation, urinary incontinence, pain, infections and urethral stricture, said Pisco.

Other treatments for enlarged prostate

Other treatments for enlarged prostrates—besides prostatic artery embolization, TURP and prostatectomy—include watchful waiting, drugs (to relax muscles near prostate to ease symptoms or help shrink the prostate) and other minimally invasive therapies (such as transurethral needle ablation and laser surgery), which have major disadvantages, such as providing less effective improvement in symptoms, poorer durability of symptomatic benefit, and greater risk of continued catheterization and reoperation.

"Additional research is needed to explain why some patients improve better than others," said Pisco.

More information about the Society of Interventional Radiology, interventional radiologists and minimally invasive treatments can be found online at

Links to More Information About Prostate Problems and Treatments

Prostate Diseases

The prostate is a gland. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine away from the bladder and out of the body. A young man's prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. This is very common after age 50. The older men get, the more likely they are to have prostate trouble.

Some common problems are

   ● Prostatitis - an infection, usually caused by bacteria

   ● Benign prostatic hyperplasia, or BPH - an enlarged prostate, which may cause dribbling after urination or a need to go often, especially at night

   ● Prostate cancer - a common cancer that responds best to treatment when detected early

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

   ● Prostate Problems (National Institute on Aging) Also available in Spanish

   ● What I Need to Know about Prostate ProblemsEasy-to-Read (National Institute of Diabetes and Digestive and Kidney Diseases) Also available in Spanish

   ● Understanding Prostate Changes: A Health Guide for Men (National Cancer Institute)

   ● Many more links at MedlinePlus

Links to topics in MedlinePlus’ Medical Encyclopedia

   ● Blood in the semen

   ● Cystoscopy

   ● Digital rectal exam

   ● Enlarged prostate

   ● Enlarged prostate - what to ask your doctor

   ● Enlarged prostate gland

   ● Frequent or urgent urination

   ● Prostate removal

   ● Prostate resection - minimally invasive

   ● Prostate resection - minimally invasive - discharge

More Links to Archived Reports on Prostate Cancer in

Prostate Cancer Victims Should Be Especially Watchful for Precancerous Colon Polyps

Study is first to show that men with prostate cancer are at increased risk of colon cancer – two most common cancers for older men

Oct. 20, 2010

Popular ADT Prostate Cancer Treatment Associated with Bone Decay

'Virtual bone biopsies' may help identify men at risk for fractures after androgen deprivation therapy

Oct. 8, 2010

Older Men with Low Baseline PSA Do Not Benefit from Early Prostate Cancer Detection

Prostate cancer is the most commonly diagnosed malignancy and the third leading cause of death from cancer in men in Western countries

Sept. 13, 2010

Most Men With Just Low-Risk Prostate Cancer Receive Aggressive Treatment

Over 90% of prostate cancers diagnosed before they spread and the 5-year survival rate for these is almost 100%

July 27, 2010

New Study Finds Gene Fusions May be ‘Smoking Gun’ in Prostate Cancer Development

Gene fusion – not the androgen receptor – is the more specific “bad actor” in prostate cancer  - May 21, 2010

Provenge Approved as Vaccine for Advanced Prostate Cancer; Activates Immune System

Survival for Provenge patients was 25.8 months, compared to 21.7 months for those receiving placebo

By staff - April 30, 2010

Prostate Cancer Treatment Choices Vary Based on Type of Specialist Men Choose to See

About half of all men seen just by a urologist; last week the attention was on the type of prostate cancer screening men should pursue - March 9, 2010

Study of Senior Men Finds Similar Results With Open or Laparoscopic Prostate Surgery

Researchers studied almost 6,000 senior citizens, suggest patients be informed about the differences and similarities in expected outcomes, make treatment decisions with an experienced surgeon - Feb. 22, 2010

ADT Therapy for Prostate Cancer Can Increase Heart Risk Factors

Androgen-deprivation therapy (ADT) may increase cardiovascular risk, but unclear whether it’s linked to increased death from heart disease - Feb. 3, 2010

Favorite Drink of Senior Citizens Coffee Appears to Fight Advanced Prostate Cancer

More good news for senior men is FDA consideration of prostate cancer vaccine, Provenge

Dec. 8, 2009

Study Uncovers Key to How ‘Triggering Event’ in Prostate Cancer Occurs

Researchers link hormone androgen to creation of gene fusion in prostate cancer, a major killer of older men; may help learn how other cancers begin

Oct. 29, 2009

Cancer Society Stands Firm: Older Women Need Mammograms, Men Need Advice on Prostate Tests

‘Mammography is effective – mammograms work and women should continue to get them,’ ACS

Oct. 23, 2009

Minimally Invasive Radical Prostatectomy Has Advantages, But Higher Rate of Complications

MIRP, especially with robotic assistance, increased from 1% to 40% of radical prostatectomies from 2001 to 2006,despite limited data on outcomes and costs

Oct. 14, 2009

Study Says Men are Not Adequately Involved in Prostate Cancer Screening Discussions

Another new study finds screened men up to four times more likely to be diagnosed with prostate cancer than unscreened men

Sept. 28, 2009

Keep up with the latest news for senior citizens, baby boomers

Study Shows Seed Implants a Suitable Prostate Cancer Treatment Option for Older Men

Prostate cancer treatment ‘outcomes are impacted by disease-related risk factors but not by age

Aug. 4, 2009

Men Who Delay Radical Treatment of Prostate Cancer Don’t Seem to Worry About It

Men with neurotic personalities and those in poor physical health exhibited more anxiety and distress than others

July 27, 2009

Heavy Alcohol Drinking Spurs High-Grade Prostate Cancer, Stops Prevention by Finasteride

Four or more drinks on 5 or more days per week doubles risk of high-grade prostate cancer

July 13, 2009

Predicting the Return of Prostate Cancer Improved by Results from John Hopkins Study

May also help resolve the debate on when, and in what form, secondary treatments should occur

July 2, 2009

PARP Drugs May Be Miracle Cure for Cancer Suggests Success with Breast, Ovarian, Prostate Cancer

NEJM editorial says PARP inhibitors may point to a new direction for anticancer drugs - watch video

June 25, 2009

Veterans Badly Mistreated for Prostate Cancer at VA Hospital, Reports NY Times

92 of 116 cancer treatments were botched during a six year period at Philadelphia unit

June 22, 2009

Prostate Cancer Test Proven to Offer Early Prediction of Bone Metastasis, Mortality

UCSF Cancer of the Prostate Risk Assessment gives patients and doctors a better way of gauging long-term risks and pinpointing high risk cases.

June 15, 2009

New Blood Test Significantly Increases Accuracy of PSA Screening for Prostate Cancer

Greatly reduces false-positives in prostate cancer screening that often require a biopsy of the gland to check for tumors

May 28, 2009

Men Should Not Give Up on PSA Prostate Cancer Screening, Just Yet

Urologists argue that men should not be swayed from getting the test - it still saves lives

May 13, 2009


Statins Protect Against Prostate Cancer, Erectile Dysfunction and Prostate Enlargement, Mayo Study Finds

Study followed older men 40 to 79 from 1990 to assess urologic outcomes among aging men

April 27, 2009

Elderly Men with Short Life Expectancy Do Not Need Prostate Cancer Screening, Study Shows

U.S. trial shows no early mortality benefit from current annual screening for prostate cancer - watch video, link in story

March 19, 2009

Enough is Enough of Prostate-Specific-Antigen Testing Once Men Reach Age 75

PSA test has decreased prostate cancer deaths but other problems more likely to kill elderly

Feb. 23, 2009

Simple Urine Test May Reveal the Aggressiveness of Your Prostate Cancer

Sarcosine is better indicator of advancing disease than traditional prostate specific antigen test (PSA); it is detected in urine, researchers hopeful simple urine test can be used

Feb. 12, 2009

Artificial Light at Night Contributes to Prostate Cancer and Breast Cancer Say Researchers

Theories for cause: suppression of melatonin production, suppression of immune system, body's biological clock confused between night and day

Feb. 3, 2009

GPS for the Body Sometimes Needed for a Moving Prostate During Radiation Therapy

Prostate can move during a treatment session and can make delivering radiation safely to the tumor a challenge

By Constantine A. Mantz, MD

Jan. 21, 2009

Selenium or Vitamin E to Stop Prostate Cancer May Do More Harm Than Good

National Cancer Institute stops clinical trial from going forward

Oct. 27, 2008

Benign Prostatic Hyperplasia Strikes Up to 90 Percent of Oldest Men, Can Be Life-Threatening

It’s Prostate Health Month and urologist say cancer is not the only thing senior citizens should watch for

Sept. 29, 2008

High Cholesterol Bad for Heart but May Also Increases Prostate Cancer Risk

September both National Prostate Health and National Cholesterol Education Months

Sept. 18, 2008

Common Painkillers Like Aspirin Seem to Lower PSA Level that Predicts Prostate Cancer

Not enough data to say that men who took the medications were less likely to get prostate cancer

Sept. 8, 2008

Height Linked to Prostate Cancer Development, Growth in Review of 58 Studies

‘We speculate that factors that influence height may also influence cancer and height is therefore acting as a marker for the causal factors’

Sept. 3, 2008

Brachytherapy May Be Best Prostate Cancer Treatment Choice for Obese Men

Follows finding that surgery is technically more challenging in overweight men

Aug. 19, 2008

Prostate Screening Bias Against Obese Men Leads to Late Detection, Less Surgical Success

Aggressiveness of obese men's late-detected tumors and that they may be more difficult to remove, is a double whammy for fat guys

Aug. 8, 2008

Task Force Says Men Age 75 and Older Should Not Be Screened for Prostate Cancer

Chances are they will die of something else before the cancer gets them

Aug. 5, 2008

Androgen Deprivation Does Not Improve Survival for Seniors with Prostate Cancer

Conservative management of the disease does a better job, says study

July 8, 2008

Radiation for Cancer Recurrence after Radical Prostatectomy Shows Increased Survival

Provocative evidence that even men with adverse prognostic features may benefit from salvage radiotherapy

June 17, 2008

Older Men With Prostate Cancer at Much Greater Risk of Bone Fractures

Patients should be checked for osteoporosis, particularly if treated with ADT

May 14, 2008


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