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Treatment of BPH – PAE vs. TURP - What’s Your Best Option?

When considering the treatment of BPH (benign prostatic hyperplasia) also referred to as an enlarged prostate gland, you may be trying to decide between PAE vs. TURP.  

Prostate artery embolization (PAE) and transurethral resection of the prostate (TURP) are two of the most common treatment options for BPH. While both aim to alleviate BPH symptoms, they are two very different procedures for men with moderate to severe BPH symptoms. This article compares the two, to help you make an informed decision.

INTRODUCTION

Traditionally, TURP has held the status of the "gold standard" for treating BPH in prostates of specific sizes. However, with ongoing medical advancements, alternative treatments like PAE have emerged. PAE is a minimally invasive approach with less than a 1% risk of major complications. Its cost-effectiveness surpasses that of TURP and other surgical options, primarily because it is conducted on an outpatient basis, eliminating the need for hospitalization. TURP, on the other hand, encounters limitations in treating certain prostate sizes, poses a greater risk of side effects, and is not recommended for individuals aged over 65.

TREATMENT OF BPH BY TYPE

Prostate Artery Embolization (PAE)

PAE stands out as a minimally invasive, non-surgical intervention characterized by reduced risks, fewer complications, a quicker recovery period, and the absence of hospitalization or general anesthesia requirements. Generally, patients can leave the clinic approximately two to four hours after the procedure and recuperate in the comfort of their homes. Additional advantages of PAE include:

Transurethral Resection of the Prostate (TURP)

TURP and PAE have notable differences across various aspects. TURP, being a more invasive procedure, is not advised for prostates exceeding 80 milliliters (ml) and poses an increased risk, especially for male patients over the age of 65. Compared to PAE, TURP is associated with a higher likelihood of incontinence, sexual side effects, and retrograde ejaculation—conditions observed in less than 1% of PAE cases. Additional points of contrast include:

PROCEDURES

Prostate Artery Embolization

A minimally invasive procedure, PAE involves the insertion of a small catheter (a tiny tube) through your groin into the artery. With the aid of advanced imaging technology, the catheter is carefully guided to the arteries supplying blood to the enlarged prostate gland. With the catheter well placed, small gelatin particles are injected into the arteries. These minuscule beads impede the blood flow to the prostate gland, initiating a reduction in its size. The duration of PAE usually ranges from one to two hours, contingent upon the size and location of the prostatic arteries.

Transurethral Resection of the Prostate

TURP is a surgical intervention typically lasting around 60-90 minutes. It involves the insertion of a slender metal tube, known as a resectoscope, through the penis into the urethra until the prostate gland is reached. The resectoscope is equipped with a light, camera, and wire. During the procedure, the wire loop is heated with an electrical current, facilitating the removal of sections of prostate tissue that obstruct urine flow. An irrigating fluid aids in transporting the excised prostate pieces into the bladder. Subsequently, a catheter is used to extract the removed fragments once the operation has ended.

RECOVERY – PAE VS. TURP

Following TURP, the catheter must remain in position for 24-48 hours post-surgery until the ability to urinate independently is regained. Typically, TURP surgery entails a hospital stay lasting 1-3 days, with a complete recovery period spanning 3-4 weeks. Patients are advised to refrain from strenuous exercise or heavy lifting for up to 6 weeks.

In contrast, the recuperation period for PAE is notably shorter. Patients typically return home on the same day as the procedure. Full recovery is generally achieved within 1-2 weeks, and most individuals resume normal activities after 10 days.

TREATMENT OF BPH – WHICH IS RIGHT FOR YOU?

At MINT, we believe in providing comprehensive information to men considering their treatment options for enlarged prostates. When weighing the choice between PAE and TURP surgery, it's vital to take several factors into account. While TURP has historically held the reputation as the most successful BPH treatment, there is a growing prevalence of other minimally invasive procedures that offer effectiveness with fewer complications and swifter recovery times than TURP.

Prostate Artery Embolization emerges as a secure, efficient, and minimally invasive treatment for enlarged prostates, alleviating the painful and uncomfortable symptoms of BPH. It boasts several advantages over TURP surgery, notably the absence of sexual side effects, reduced post-procedural pain, and a lower incidence of complications. At MINT, we recommend PAE to alleviate your BPH symptoms and enhance your overall quality of life.

Interested in PAE?

At MINT, our highly experienced Board-certified Interventional Radiologists give each patient personalized care at their offices in Evergreen Park, IL, St Louis, MO, Swansea IL, and Chicago IL. Why not schedule a consultation to see how we can help?

 

 

 

 

 

 

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