Why Minimally Invasive BPH Procedures Don’t Last Forever
Patients should be aware that, depending on their age, degree of prostatic growth, and the technique chosen to address BPH symptoms, they may need multiple procedures over their lifetime.
BPH, or benign prostatic hyperplasia, is a very common condition that most men will experience at some point after the age of 50. In fact, half of all men over 60 and more than 80% of men over 80 will have the condition.¹
Prostatic enlargement is not cancerous, though the two can coexist. Rather, this is just a natural part of aging, and one that can be readily treated. Because of its ubiquitous nature, you can imagine how much research has been put into its treatment. We have therapies ranging from minimally invasive five-minute steam-based procedures to complex surgical procedures, all of which have the goal of improving the symptoms associated with an enlarged prostate.
The simple explanation for some of these procedures not offering a lifetime of relief revolves around two important concepts.
The first is that the prostate is not a static organ. In other words, the prostate continues to grow over the entirety of a man’s life. This means that after treatment, and especially with a minimally invasive procedure, the prostate will grow again and eventually cause certain symptoms.
Secondly, minimally invasive procedures do not remove as much prostatic tissue as, for example, an operating room procedure. As such, these in-office procedures may lose their effectiveness much sooner. On the other hand, more invasive prostate surgeries like Aquablation, HoLEP (Holmium Laser Enucleation of the Prostate), GreenLight Laser, simple prostatectomy, and TURP (Transurethral Resection of the Prostate) may remove enough tissue that a patient will have relief for upwards of a couple of decades, or even a lifetime. With many less invasive procedures, the relief remains for about three to seven years.
Introducing Prostatic Artery Embolization
We are very excited to introduce prostatic artery embolization (PAE) to the spectrum of treatment options at Georgia Urology. PAE is a procedure in which a tiny catheter is threaded down to the prostatic arteries from a small puncture in the wrist or the groin. Once in place, tiny pellets, or what we call microspheres, are pushed into the artery, reducing the amount of blood flow to the prostate and shrinking it by up to 40%. Because this does not involve the urethra, the tube that carries urine, many of the associated risks, such as damage to the urethra or scar tissue formation leading to a stricture, can be avoided.
Depending on the level of symptoms and size of the prostate, PAE can be very effective. One study followed 1,075 patients, and one year after PAE, 66% of patients did not need medication for prostatic symptoms. Symptom scores also went from 23 to 6 at year one and to 9 at years four to five.²
Further, PAE does not preclude the use of any minimally invasive or surgical BPH procedure in the future.
The Bottom Line
Discussing the best procedure based on your prostate size and goals with your urologist is an important first step to making the right decision. We encourage you to contact our team at Georgia Urology and schedule a consultation with one of our surgeons to understand more about BPH treatment and the best procedures for you.
Reference:
- Harvard Medical School. (2024, August 10). The growing problem of an enlarged prostate gland. Harvard Health; Harvard Health Publishing. https://www.health.harvard.edu/mens-health/the-growing-problem-of-an-enlarged-prostate-gland.
- Bhatia, S., Bhatia, A., Richardson, A. J., Richardson, K., Issa, C., Kumar, J. G., Jalaiean, H., Kava, B., & Shah, H. N. (2025). Prostate Artery Embolization – Mid to Long-term Outcomes in 1075 Patients. Journal of Vascular and Interventional Radiology, 36(3). https://doi.org/10.1016/j.jvir.2024.11.002.
