Dr. Insausti has extensive experience in the field of prostate embolization, being the specialist who has performed more procedures in Spain. He teaches courses on prostate embolization to other Spanish and European doctors through TERUMO's workshops. In addition, it has carried out a pioneering clinical trial together with the Interventional Vascular Radiology and Urology Services, which demonstrates the great efficacy and safety of prostatic embolization in the treatment of urinary symptoms caused by benign enlargement of the prostate size (benign prostatic hyperplasia).
Benign Prostatic Hyperplasia (BPH) is a pathology where a benign enlargement of the size of the prostate occurs, producing urinary symptoms such as nocturia (going to the bathroom many times during the night), increased frequency and urgency of urination, urinary incontinence, sensation of incomplete bladder emptying....
BPH affects approximately 50% of patients aged 60 years and older, and up to 75% in patients over 70 years.
The treatment of choice for the symptoms produced by BPH is medical treatment with alpha-blockers, 5alpha reductase inhibitors, and anticholinergics (when symptoms are more irritating).
When medical treatment is not effective, and symptoms are moderate to severe, the standard treatment so far has been TURP (transurethral resection of the prostate), which is endoscopic surgery performed through the urethra. It is a surgery that is usually performed under general anaesthesia, with an average stay of 2-3 days in the hospital, and the patient goes home with a urinary catheter. It is an effective and safe surgery, but it has complications such as: bleeding, incontinence, retrograde ejaculation (65%-ejaculation into the bladder), erectile dysfunction (6.5%)...
Prostatic Embolization is a novel alternative but with proven safety and efficacy in the treatment of BPH. It is a minimally invasive procedure, it is not a surgery. Through a puncture in the femoral artery, the prostate arteries are closed with particles called microspheres, first on the left and then the right side. Blockage of the prostatic vessels decreases the size of the prostate and corresponding symptoms improve.
After embolization most patients have a great improvement in their urinary symptoms 3-4 days after the procedure. 88% of patients with urinary catheterization who have prostate embolization are without a catheter at 3 weeks.
Risk & Complications. The most frequent complications are:
1) Urinary tract infections (treated with antibiotics) and blood in urine (self-limited) occur in about 8 – 10%
2) Blood is in semen (self-limited) is about 5%
3) Blood is stool in 3% (self-limited)
4) Burning in anus and uretra for some hours (self-limited) it last for some hours
5) Urinary retention during the procedure (1%) treated with a bladder catheter for a couple of hours
Prostate Embolization has been shown to be the same and even more effective and safe as surgical treatment, but with fewer complications. In addition, it does not require anaesthesia, is completely painless, and allows for an almost immediate incorporation into daily work and social life.
It is a particularly good option for men who are not yet ready to undergo more invasive prostate surgery. Maintaining sexual function and fertility is one of its main strengths.