New Therapy May Shrink Enlarged Prostate With Fewer Side Effects: Study

MONDAY, March 24, 2014 (HealthDay News) -- A new noninvasive procedure may bring long-term relief from symptoms caused by an enlarged prostate, a new study suggests.

As men age, the prostate gland grows larger and may begin to press on the urethra. Enlarged prostate affects more than half of men by age 60 and causes symptoms such as frequent urination, weak urine stream and a persistent feeling of having to urinate.

Surgery is the standard treatment for the condition, but can cause complications such as sexual dysfunction and impotence, experts note.

The new treatment is called prostate artery embolization. "Prostate artery embolization is a promising therapy that has been performed outside the United States to improve men's symptoms," explained Dr. Man Hon, chief of interventional radiology at Winthrop University Hospital in Mineola, N.Y.

"This procedure works by closing the blood supply to the prostate," said Hon, who was not involved in the new study. "As a result, the prostate shrinks in size, causes less blockage, and the symptoms improve."

The study was conducted in Portugal and included nearly 500 men, aged 45 to 89, with enlarged prostate -- formally called benign prostatic hyperplasia -- who underwent prostate artery embolization.

Improvements in symptoms were reported by 87 percent of men three months after the procedure, 80 percent after 18 months, and 72 percent after three years. The procedure did not cause sexual dysfunction or impotence, according to the findings, which were slated for presentation on Monday at the annual meeting of the Society of Interventional Radiology (SIR), in San Diego.

"The results of prostate artery embolization (PAE) are similar to surgery but with fewer complications," study author Dr. Martins Pisco, director of radiology at Saint Louis Hospital in Lisbon, said in a meeting news release. "Patients are discharged three to six hours after the treatment with most of the individuals we've treated noting almost immediate symptom relief."

"I believe PAE could eventually become standard treatment for enlarged prostate," he added.

However, Dr. James Spies, president elect of SIR, stressed that further studies are needed before the procedure could become widely available. Also, studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Another expert agreed that more study is needed. Dr. Manish Vira is director of the Fellowship Program in Urologic Oncology at The Arthur Smith Insitute for Urology in New Hyde Park, NY. He pointed out that the Portuguese study was not designed to compare the success rate of embolization to that of other treatments.

However, Vira added that "the results are especially significant given the very low complication rate and no incontinence. If these results are replicated in the ongoing U.S. trials, then prostate artery embolization will become an attractive treatment option" for men with enlarged prostate who have not responded well to other treatments.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Manish A. Vira, M.D, director, Fellowship Program in Urologic Oncology, The Arthur Smith Institute for Urology, New Hyde Park, NY; Man Hon, M.D, chief, interventional radiology, Winthrop University Hospital, Mineola, NY; Society of Interventional Radiology, annual meeting news release, March 24, 2014

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Early Course of HIV Therapy May Give Infants a Break From Drugs

WEDNESDAY, Aug. 21 (HealthDay News) -- Giving immediate drug therapy to HIV-infected infants for a limited period of time protects their immune system and delays the start of lifelong treatment, according to a new study.

HIV is the virus that causes AIDS.

Currently, infants who begin so-called antiretroviral therapy must continue for life. However, long-term use of the therapy increases their risk of drug-related toxicity and drug resistance, according to background information in the study published Aug. 22 in The Lancet.

"This important finding indicates we may be able to temporarily stop treatment and spare infants from some of the toxic effects of continuous [antiretroviral therapy] for a while, if we can monitor them carefully," study co-leader Mark Cotton, a professor at Stellenbosch University in South Africa, said in a journal news release.

"With [antiretroviral therapy] coverage in children currently at just 28 percent, our findings highlight the urgency of increasing early (within the first 3 months of life) testing and treatment of HIV-infected infants," he added.

The researchers looked at five years of follow-up data from 377 HIV-infected infants who, at ages 6 weeks to 12 weeks in 2005, were randomly selected to begin immediate short-term antiretroviral therapy of 40 weeks or 96 weeks, or to wait until they showed signs of illness or a weakened immune system before beginning treatment.

On average, infants in the delayed-treatment group needed to begin taking lifelong therapy 20 weeks after the start of the study. In comparison, those completing the immediate course of treatment for 40 weeks were able to then delay restarting treatment for an average 33 weeks, and those who completed the immediate course of 96 weeks of treatment were able to delay restarting treatment for an average 70 weeks, the investigators found.

By the end of the trial, nearly 20 percent of infants who were given 40 weeks of early treatment and about one-third of infants who received 96 weeks of initial antiretroviral treatment were still well enough to avoid restarting what would eventually become lifelong treatment.

The researchers also found that the delayed-treatment group had a significantly higher number of deaths and hospital admissions, and had higher health care costs than the groups of infants who received immediate, temporary antiretroviral therapy.

"Early treatment followed by a break is definitely better and more cost-effective than delaying starting infants on treatment. But we do not know if a longer initial period of treatment, or early continuous treatment, might be even better," study co-leader Dr. Avy Violari, from the University of the Witwatersrand in South Africa, said in the news release.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: The Lancet, news release, Aug. 21, 2013

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