Interventional Radiology Takes on a New Condition

An enlarged prostate can seriously impede daily life functions. Benign prostate hyperplasia, or an enlarged prostate affects 80 percent of males, and that same percentage experience complications such as urinary retention and kidney damage. Traditional remedies include invasive surgery, cutting the tissue out, and other advancements that diminish the prostate’s size by using lasers or microwave energy. Although these procedures are usually effective, they result in bleeding, urinary incontinence, and extensive recovery time that take weeks.

Assistant professor of radiology at Yale University, Raj Ayyagari, MD, has developed an experimental procedure called prostatic artery embolization, which shrinks the prostate, and might be considered a safer alternative to trans-uethral resection of the prostate (TURP). According to Ayyagari, TURP is only beneficial for those with prostate glands smaller than 100 to 120 milliliters. Glands larger than that are usually too difficult for a urologist to clean.

Ayyagari has now performed prostatic artery embolization around 65 to 70 times. The outpatient procedure involves “mild sedation” while lodging a tube through the wrist or groin. The tube is then maneuvered into the small arteries that connect to the prostate. Ayyagari then injects thousands of microscopic beads that clog up the artery, deterring blood flow to the prostate gland. This process shrinks the prostate from the size of a grape to the equivalent of a raisin. Although Ayyagari claims that the procedure improves urinary flow, although about 25 percent of patients experience temporary bladder spasms during recovery.

“Usually by about two to four weeks, most patients will notice significant improvement and then the shrinking continues over three to four months so they just get better and better over that time,” Ayyagari told the New Haven Register.