Treatment of enlarged prostate by catheterization by coagulation of the prostatic artery by catheterization and without surgery
First of all, what is an enlarged prostate?
It's called an enlarged prostate.Benign prostatic hyperplasia (Benign Prostatic Hyperplasia BPH) in BPH Medicine.
It is an enlargement of the prostate gland due to age. Where it causes some complaints in men.
Prostate enlargement is one of the most common diseases in men. About half of men in their fifties and about 80% of men in their eighties have complaints of Prostate enlargement.
The most common symptoms of an enlarged prostate are:
- Frequent urination (especially at night).
- A sudden urge to urinate.
- Difficulty starting urination.
- Pain or burning sensation.
- Feeling of incomplete emptying of the bladder.
- drip or incontinence
- Weak urine flow during urination.
How is benign prostatic hyperplasia diagnosed?
BPH can be easily diagnosed by performing some examinations and tests for patients with the above complaints.
Digital (digital) rectal examination,
PSA blood test,
Transrectal ultrasound USG.
And check urine flow.
Through these methods, the diagnosis of BPH is made, the degree of enlargement is determined and other prostate diseases are excluded.
What are the treatment options?
The most common methods used in BPH are medication and surgery.
At first, medication is usually attempted.
However, over time in most cases, complaints increase and surgery becomes necessary.
The most common operation in BPH is TURP (Transurethral resection of the prostate).
In this procedure, the prostate is reached by inserting a thin tube into the urethra (from the opening of the urinary canal) and the middle part of the prostate that narrows the canal is excised.
after surgery Transurethral resection of the prostateThe patient can go home after staying in the hospital for a few days.
Transurethral resection of the prostate (TURP) is a successful method for relieving prostate complaints, but it has some side effects.
Most common side effects
he is retrograde ejaculationRetrograde ejaculation is the flow of semen back into the bladder during orgasm and not out of the penis.
The semen accumulated in the bladder comes out with urine during the next urination.
Another common side effect after transurethral resection of the prostate is bleeding. Although bleeding gradually decreases after the procedure, it may last for weeks.
After TURP, some complications may arise, although they are less frequent:
ED:
Most importantly, some patients may experience decreased erection after transurethral resection of the prostate.
This condition is more common in patients who had erectile dysfunction before the procedure.
incontinence:
After TURP, urinary retention problems may occur due to persistent bladder problems or damage to the urethral muscles (the closed muscles of the urethra).
In most cases, it disappears for a period of time until the urinary system adapts to the new situation.
Urethral stricture:
The scar tissue that forms after the operation may narrow the urethra after transurethral resection of the prostate and the patient may have difficulty urinating again. In this case, it may then be necessary to dilate the urethra by special methods.
infertility:
If retrograde ejaculation occurs, pregnancy is not possible naturally because semen does not come out during intercourse.
Transurethral resection of the prostate can sometimes be performed laser.
In this method, the tissue is not cut, but rather burned and reduced. Because the bleeding is less, it is particularly preferred in patients who use blood thinners, but this method may also cause the same complications.
What is the catheter embolization (coagulation) method for prostatic hypertrophy in Turkey?
Embolization is the coagulation or closure of the vessels of a tissue or organ through a catheter.
This procedure is usually performed by an interventional radiologist. The organ whose vessels are blocked does not lose its function, but becomes noticeably smaller.
The embolization method has been successfully used in medicine for decades to stop bleeding, reduce or kill cancerous tissue, and for the non-surgical treatment of E.uterine fibroids removal.
But the use of embolization in an enlarged prostate is more recent.
It was first applied in 2011 by Portuguese and Brazilian interventional radiologists with successful results.
Prostate embolization has been applied with increasing frequency in many countries of the world in the past five years and many cases of prostatic hypertrophy have been cured by this method.
How is transcatheter embolization of the prostate artery performed without pain?
The patient is inserted into the CT scan machine.
After that, the catheter is inserted through the inguinal artery (femoral artery) under local anesthesia as in cardiac catheterization, and the arteries supplying the prostate are identified.
Then very small particles are injected into the vessels that supply the prostate through the catheter, and these vessels are closed off.
Prostate tissue whose vessels have been closed gradually become smaller.
And relieve pressure on the urinary channels that pass through the prostate. Thus, the problems caused by the enlarged prostate of the patient decrease or disappear significantly.
After embolization, the prostate shrinks but does not lose its vitality or function because it continues to nourish, even a little, from the vessels of the surrounding organs.
What are the advantages of prostate embolization (coagulation)?
The operation is performed under local anesthesia and without pain.
Who are the most suitable patients for catheterization of prostatic hypertrophy in Turkey?
Embolization therapy is more beneficial and technically more comfortable for patients with a large prostatic hypertrophy (80 g and above). In such patients, doctors previously recommended open prostate surgery, which has more side effects than traditional TURP, so surgical treatment is not ideal.
On the other hand, in patients with a large prostate, it is technically easier for the prostate vessels to enter and close because they are also larger.
The application of embolization is easier in these patients, especially if the structure of the blood vessels is not damaged by blood pressure, diabetes, and atherosclerosis.
As a result, patients who are most suitable for catheterization of an enlarged prostate are patients with prostate volumes greater than 80 grams who do not have a severely altered vascular structure.
Doctors also recommend an Anjio CT (computed tomography) angiography (CT) scan prior to embolization to examine the structure of patients' blood vessels, to see if the patient is suitable for embolization.
Because it is possible that patients have a change in the structure of the blood vessels supplying the prostate.
end by end studies Transurethral resection (TURP) is still the gold standard for treating enlarged prostate with catheters so far, but for elderly patients who are afraid of operations, coagulation therapy is a very suitable option for them, especially if the imaging equipment is advanced and the staff is experienced in this process.
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It is worth noting that this method of treatment is used byTreatment of uterine tumors in women.
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