“Although we do not yet have the benefit of long-term international clinical trials, prostatic artery embolisation (PAE) is showing promising results internationally. We believe it is important to introduce it to South Africa through a formal training programme, says Dr Stephen Cornish, a urologist who practises at Netcare Sunninghill Hospital in Johannesburg.
Four PAE procedures were recently performed at the hospital as part of a two-day workshop, organised by Dr Cornish and interventional radiologists, Dr Farrell Spiro and Dr Andrew Lawson.
The procedures were performed by Dr Lawson under Dr Nigel Hacking, an international proctor for PAE and currently one of the world’s leading interventional radiologists performing this procedure.
According to Dr Cornish, an enlarged prostate, or benign prostatic hyperplasia (BPH), is the most common non-cancerous prostate medical condition faced by men by the time they reach their 60s.
“PAE was introduced in Brazil and Europe some seven years ago and has since become an increasingly popular alternative around the world, to traditional surgery.”
“Among the reasons why PAE is proving so popular among patients internationally is that it is minimally invasive; it does not require large surgical incisions to be made, just one small puncture wound in the groin.
“As a result, there is a reduced risk of complications from the procedure and patients tend to recover much more quickly. They are usually treated as outpatients and are able to go home on the same day, as opposed to the one or two nights they would likely have had to spend in hospital after open surgery. In addition, and importantly, erectile function is preserved,” says Dr Cornish.
Dr Spiro and Dr Lawson will be the principal interventional radiologists involved in offering this service.
“A catheter is inserted through the puncture wound in the groin and guided toward the arteries supplying blood to the areas of the prostate that are most affected. The entire procedure can take up to three hours, but the patient remains awake at all times. There is no pain associated with the procedure itself,” says Dr Lawson.
“Once at the site, the embolisation is performed by injecting tiny particles which block the blood flow to the prostate, causing it to shrink. Over a number of months, the prostate shrinks down to approximately 40% of its original size, resulting in a meaningful reduction in symptoms,” notes Dr Spiro.
Dr Lawson says that PAE is an intricate procedure that requires a high degree of skill to master. “For this reason, we felt that it was vital to partner with local specialists with expertise and experience in interventional work. We also decided to introduce PAE through a proper training programme, which gives local doctors the opportunity to develop the necessary skills which will enable them to become thoroughly familiar with this new treatment approach.”
Dr Lawson says that a follow-up workshop with the international proctor is planned for August 2016. Once this workshop has been completed, the procedure will be formally offered at the hospital.
