Enlarged Prostate (BPH)

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Enlarged Prostate (Benign Prostatic Hyperplasia – BPH)

Benign prostatic hyperplasia (BPH) is noncancerous enlargement of the prostate gland, a common occurrence in older men.

The prostate is a part of male reproductive system and prostate is walnut-shaped gland. Prostate makes fluid that is directed towards semen. Prostate fluid is essential for a man’s fertility. The prostate gland is located beneath your bladder. It transports urine from the bladder through the center of the prostate. Due to prostate enlargement, there is blockage in urine flow.

What are the symptoms of benign prostatic hyperplasia (BPH)?

As the prostate starts getting larger, it pinches the urethra. This causes symptoms that affect your urine flow. People suffering from prostate gland enlargement may have different symptoms, however common signs and symptoms of benign prostatic hyperplasia(BPH) include:

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night
  • Difficulty starting urination
  • The sensation of full bladder, even after you’ve just passed
  • Weak urine stream or an interrupted stream that stops and starts
  • Dribbling at the end of urination
  • Inability to completely empty the bladder
  • Urine leakage


The prostate gland is located beneath your bladder. The transportation tube that directs the urine from the bladder out of your penis (urethra) passes through the center of the prostate. Due to prostate enlargement, there is blockage in urine flow.

Most men have continued prostate growth throughout life. In many men, prostate keep on growing enough to cause urinary symptoms or to significantly block urine flow.

Prostate enlargement reasons are still not known. However, it is believed that it may be due to changes in the sex hormones as men grow older.

Risk factors

Risk factors for prostate gland enlargement include:

  • Aging: Prostate gland enlargement rarely shows signs and symptoms in men below 40 years of age. One-third of men experience moderate to severe symptoms by the time they touch 60 years of age, and about half experience prostate gland enlargement by age 80.
  • Family history: Blood relation, such as a father or a brother, with prostate problems means you're more likely to have problems.
  • Diabetes: Studies show that diabetes has an important role in the development of BPH. High insulin levels can trigger prostate growth.
  • Obesity: Obesity increases the risk of BPH, while exercise can lower your risk.
  • Inactivity: Inactivity contributes to urine retention. Even very less time spent on exercise can help reduce urinary problems caused by an enlarged prostate.


Complications of an enlarged prostate can include:
  • Urinary retention: Patient suffering from prostate enragement might need a a tube (catheter) inserted into the bladder to drain the urine. While some patients with an enlarged prostate may be advised surgery to relieve sudden inability to urinate.
  • Urinary tract infections (UTIs): Inability to fully empty the bladder can increase the risk of infection in your urinary tract. If UTIs occur frequently, you might need surgery to remove part of the prostate.
  • Bladder stones: Bladder stones occur in men who have inability to completely empty the bladder. Bladder stones can cause infection, bladder irritation, blood in the urine and obstruction of urine flow.
  • Bladder damage: A bladder that hasn't emptied completely can stretch and weaken over time. Therefore, bladder’s muscular wall no longer contracts properly, and make it harder to fully empty your bladder.
  • Kidney damage: Pressure in the bladder due to urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys.

Acute urinary retention and kidney damage can be serious health threats to a person having enraged prostate.

Having an enlarged prostate is not believed to increase your risk of developing prostate cancer.

Non Surgical Treatment: Prostate Artery Embolization (PAE)

Prostate Artery Embolization (PAE) is a latest, Non-Surgical procedure to treat Benign Prostatic Hyperplasia – BPH (प्रोस्टेट का बढ़ना) that can, be performed on a daycare basis without need for General Anesthesia or Blood Transfusion. Prostate Artery Embolization shrinks the prostate by blocking the blood supply with the use of special microsphere particles delivered through a catheter (tube), using special Angiography Machine. Many Clinical studies have been performed in last 5 years, and a very recent study showed that Embolization is an effective and safe procedure to treat symptomatic Prostate with good results.

Prostate Embolization is very challenging procedure and should only be performed by a technically trained & certified vascular specialist called Interventional Radiologist like Dr. Sheorain who has undergone dedicated training for PAE.

Dr. Sheorain in among very few in India who is certified to performs PAE and he is always happy to offer this treatment to the needy in our country.

Advantages of Prostatic Artery Embolization ( PAE)

Some potential advantages of PAE include:

  • No hospitalization required. Patients are normally allowed to go back to home three hours after the procedure. The most common surgical treatment option for BPH, transurethral resection of the prostate (TURP), requires up to two months of downtime and multiple nights spent in the hospital.
  • As a nonsurgical procedure, patients who undergo PAE can enjoy a lower risk of complications.
  • A small incision is made in the thigh or wrist. Patients experience minimal discomfort during the procedure.
  • PAE procedure need no general anesthesia. It needs mild sedation.
  • PAE patients can expect a much quicker and more comfortable recovery alongside their improved symptoms.
  • PAE can be performed on any size of enlarged prostate.
  • Few reported side effects.
  • Success rate is about more than 98%.

Important Information:

Prostate Embolization is technically challenging procedure and should Not be performed by those not trained to do so. It should only be performed by a trained & certified vascular specialist called Interventional Radiologist like Dr. Sheorain who has undergone dedicated training for PAE.

Dr. Sheorain in among very few in India who is certified to performs PAE and he is always happy to offer this treatment to the needy in our country.

Dr. Sheorain with few of his patients during follow up.

Why do I have Prostatic Artery Embolization?

As the prostate gets bigger, it constrict or partly block the urethra (Urine pipe), causing following symptoms such as:

  • Urinary incontinence ( Urine leaking to complete loss of bladder control)
  • Irritation during passing urine.
  • Increased urinary frequency, urgency, and pain upon urination
  • For some patients, these symptoms interfere with their quality of life.

How do I know if Prostatic Embolization is right option for me?

The PAE procedure is for those patients who are either Not fit for Surgery or Not interested in traditional surgery (because of side effects of the Surgery). When you visit Dr.Sheorain in his OPD, he can determine if you are a right candidate for PAE. During appointment, you may be asked about your urinary symptoms, how severe they are, and how much they affect your quality of life etc.

Pre-procedure workup usually includes:
  • Urine test
  • PSA test is done to help rule out prostate cancer.
  • MRI &/or Ultrasound of the prostate gland.

What happens during the Prostatic Embolization Procedure?

  • PAE is performed without any surgery by an experienced interventional radiologist like Dr.Sheorain.
  • A Urinary catheter may be inserted into your urethra.
  • PAE is performed through a small catheter inserted into the artery in your wrist or groin.
  • Angiography is done to map the blood vessels feeding your prostate.
  • Specilist like Dr.Sheorain will then guide the catheter into the vessels that supply blood to your prostate.
  • Small particles aka microspheres are injected through the catheter into the blood vessels that go to your prostate to reduce its blood supply.
  • After this procedure the prostate gland will shrink over time, relieving and improving symptoms usually within days of the procedure.

What are the risks if I go for Prostatic Embolization?

PAE should only be performed by knowledgeable and trained interventional radiologists. Sometime patients experience “post-PAE syndrome” for few days following the procedure, which can include feeling of nausea, vomiting, mild fever, mild pelvic pain, or painful or frequent urination.

Other symptoms that can occur after procedure include blood in the urine, semen, or stool; bladder spasm; or infection of the puncture site or prostate.

Why there is Need for a Newer Treatment method like Embolization when I can go for available Surgical options?

  • The PAE or Embolization procedure has a very very lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction), when compared with more invasive surgical procedures such as a TURP aka TransUrethral Resection of the Prostate.
  • There is No risk of Blood loss.
  • No need to long stay in hospital.

When to see a doctor?

Contact a doctor for any of the following symptoms. These symptoms are even more significant if accompanied with high fever and chills:

  • Urinary burning or pain
  • Difficulty passing urine
  • Difficulty or pain when starting urination
  • Pain in the genital area
  • Pain with ejaculation

If a person develops high fever with chills or a new onset of difficulty in urinating, seek medical care immediately or go to a hospital's emergency department because the infection may be spreading to other areas of the body.


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