Prostate artery embolization also suitable for older men

This study examined prostate artery embolization as a minimally invasive procedure to reduce prostate size in older men with benign prostatic hyperplasia (BPH).

The researchers concluded that prostate artery embolization is a safe and effective treatment option for younger as well as older men wit BPH.

BPH can lead to bothersome urinary symptoms that often require surgery targeting the enlarged prostate tissue. Recently, prostate artery embolization (PAE) has emerged as a promising minimally invasive procedure to reduce prostate size without actually removing prostate tissue. During PAE, a small catheter is placed in the groin. Particles are injected into the local arteries, which decreases blood supply to the prostate, and therefore reduce prostate size. Since BPH is more common with increasing age, the safety and effectiveness of PAE needs to be fully established in older men.

This study included 157 men with BPH. Of these, 52 men were aged 75 years or older. All men received treatment with PAE. Treatment outcomes were compared between older (aged 75 years or older) and younger (aged less than 75 years) men.

Overall, PAE was well-tolerated across all age groups and no major complications were reported. Older men were associated with longer procedure time and hospital stay. However, this did not affect PAE outcome. Successful embolization (decreased blood supply to the prostate) immediately after the procedure was noted in 90% of older men, and in 95% of younger men. One month after the procedure, 94% of the older men reported significant improvements in urinary symptoms and quality of life scores, as did 96% of younger men. This remained largely unchanged at one-year follow-up (92% treatment success in older men and 94% in younger men). Other factors, including prostate volume, bladder voiding, and prostate-specific antigens (an indicator of prostate growth) also significantly improved in both age groups.

However, older men were more likely to experience minor complications, including urinary retention (an inability to pass urine, reported in 31% of older men and in 9% of younger men), and a burning sensation (reported in 19% of older men and in 11% of younger men). Blood in urine, blood in sperm and local bruising were also observed (in less than 10% of men). Most reported side-effects were mild to moderate, and resolved within one week. No PAE-specific complications were noted during the follow-up period. 

The researchers concluded that prostate artery embolization is a safe and effective treatment option for BPH, even in older men.

Larger clinical trials are needed to confirm the preliminary results of this study.