[United Daily News Yuan-Chi Network Report] Can a 90-year-old patient with an extremely enlarged prostate still be evaluated for minimally invasive treatment? Dr. Lin Chun-yu shares a PAE case study
Media Report ｜ United Daily News (UDN) Health
In addition to medication and transurethral surgery, are there other treatment options for benign prostatic hyperplasia (BPH) patients who are elderly, have large prostate volumes, or have concerns about conventional surgery and anesthesia risks?
UDN Health previously interviewed Dr. Chun-Yu Lin, currently a physician at the men's special clinic of Hsi Clinic, reporting on a case of a 90-year-old male who underwent minimally invasive prostatic artery embolization.
90-year-old patient with recurrent urinary retention, prostate volume exceeding 300 grams
The patient in the report suffered from severe BPH and, starting from early 2024, repeatedly went to the emergency room for catheterization due to urinary retention, eventually requiring a long-term urinary catheter.
An examination revealed that his prostate volume had exceeded 300 grams, classifying it as a giant prostate. Considering the patient's advanced age, prostate volume, and risks associated with general anesthesia and traditional surgery, the medical team evaluated and decided to perform minimally invasive catheter intervention.
After the treatment, the patient successfully had the catheter removed, and his urination improved.
Dr. Chun-Yu Lin: Prostatic arteries are tiny; preoperative image interpretation is extremely important
Prostatic Artery Embolization (PAE) follows a different route compared to traditional transurethral surgery.
Interventional radiologists enter the vascular system through an artery, locate the tiny arteries supplying the prostate under image guidance, and then selectively guide the catheter into the target vessels for embolization. This reduces prostate blood flow, causing the gland to gradually shrink, thereby improving lower urinary tract symptoms caused by BPH.
Dr. Chun-Yu Lin pointed out in the report that the prostatic artery itself is a tiny vessel with many anatomical variations. Therefore, preoperative imaging can be used to understand the potential opening locations and courses of the prostatic arteries on both sides, assisting in the subsequent catheter treatment.
This is also what makes prostatic artery embolization very different from general prostate treatments—PAE not only involves the prostate itself but also relies heavily on vascular anatomical interpretation, image guidance, and catheter intervention techniques.
Entering from the hand artery, reducing the inconvenience of groin puncture
In this case, Dr. Chun-Yu Lin utilized his experience in "distal radial artery intervention" to establish the catheter path from the hand artery rather than the commonly used femoral artery in the groin.
The suitable vascular access route varies for different patients and must still be individually evaluated by the physician based on vascular conditions, overall physical status, and preoperative imaging.
BPH treatment is not limited to "taking medicine or having surgery"
There are many treatment methods for BPH, including medication, different types of transurethral surgeries, and prostatic artery embolization (PAE).
The characteristic of PAE is that it is non-transurethral and does not involve removing prostate tissue, and it is usually performed under local anesthesia. However, it is not suitable for all BPH patients, nor can it replace all traditional surgeries.
What truly needs to be confirmed is:
Are the current urinary symptoms caused by BPH? How large is the prostate? How is the bladder function? Are the vascular conditions suitable for PAE?
Therefore, if you already experience frequent urination, nocturia, a weak urinary stream, residual urine sensation, or have even experienced urinary retention, the first step is still to complete a urological evaluation and then discuss a suitable plan based on individual symptoms, prostate volume, and treatment needs.
Dr. Chun-Yu Lin ｜ Hsi Clinic Prostatic Artery Embolization PAE
Dr. Chun-Yu Lin is currently a PAE catheter intervention physician at the men's special clinic of Hsi Clinic, specializing in prostatic artery embolization, varicocele embolization, and various image-guided vascular interventional treatments.
Hsi Clinic has established an angiography operating suite in the Daan District of Taipei City. Prostatic artery embolization, from evaluation, image interpretation, and catheter treatment to post-operative follow-up, can all be completed within the clinic.
If you are already undergoing BPH treatment in urology, but:
Medication efficacy is limited
The prostate volume is relatively large
Have experienced urinary retention or required catheterization
Have concerns about transurethral surgery
Want to know if you are suitable for prostatic artery embolization
You can bring existing PSA, prostate ultrasound, urine flow rate, or other imaging data for further evaluation by the physician.
Extended Reading: What is Prostatic Artery Embolization (PAE)? Treatment Process, Costs, Recovery Period, and Suitability Conditions
Media Source: UDN Health
Original Report Date: June 17, 2024
This article is compiled from public media reports and supplemented with current medical information. Individual patient conditions, vascular anatomy, and suitable treatment methods vary; actual treatment still requires a complete evaluation by a physician.
