New non-invasive treatment for men with enlarged prostate

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In a new study, researchers used noninvasive pulsed electromagnetic field therapy (PEMF) to treat men suffering from benign prostatic hyperplasia (BPH).

After one month of treatment, prostate volume and symptoms significantly decreased. Men with moderate-severe lower urinary tract symptoms and without metabolic syndrome benefitted more from the treatment.

The research was conducted by a team from Sapienza University in Rome.

Most men over the age of 50 will develop enlarged prostate, or BPH. The walnut-sized prostate gland produces prostatic fluid, which is a main component of semen.

It can grow to the size of a lemon by the time a man is 60 years of age and may press against the bladder and urethra.

BPH includes chronic lower urinary tract symptoms, such as frequent and urgent urination, sense of incomplete bladder emptying, and decreased force of the urine stream.

A common complaint is having to get up at night to urinate. Approximately 60% of men over the age of 60, and 80% of men over the age of 80, will experience the symptoms of BPH.

Risk factors for BPH include age, diabetes, heart disease, high blood pressure, and metabolic syndrome. The etiology of the disease is not completely known, but inflammatory damage is the most likely cause.

Inflammation triggers fibrosis and lack of oxygen to affected tissue, resulting in structural changes in the prostate.

This creates a cycle of inflammation-fibrosis-hypoxia-inflammation, which in turn causes glandular remodeling and tissue growth.

Traditional treatment options for BPH include medications such as alpha-blockers and 5α-reductase inhibitors or surgical interventions.

Side effects of treatments may include the inability to ejaculate, retrograde ejaculation (semen flows backwards into the bladder), erectile dysfunction, and even loss of bladder control.

Some men affected have reported that taking saw palmetto, an herbal supplement, gives them relief but clinical evidence for its effectiveness is not conclusive.

Clearly, effective and less invasive treatments for this common disease are needed.

In the new study, the team used PEMF to treat this health problem.

PEMF consists of low-frequency pulsed energy waves and has been used for a variety of ailments such as various orthopedic conditions.

For example, PEMF has been shown to reduce pain and improve function for those afflicted with osteoarthritis.

The electromagnetic field is produced by a device that reduces inflammation by promoting the growth of new blood vessels, dilation of blood vessels, and tissue remodeling.

The overall effect is the reduction in tissue hypoxia. These aspects of PEMF make it an ideal noninvasive option to treat BPH.

In the study, 27 patients with BPH and lower urinary tract symptoms were tested. They received a battery of tests including transrectal ultrasound and standardized questionnaires at baseline.

They then used a handheld PEMF device (Magcell Microcirc, Physiomed Elektromedizin) for five minutes twice daily for 28 consecutive days. The tests were then repeated.

Nine patients elected to continue therapy for three more months while others discontinued. A final health evaluation was completed at four months for all patients.

The patients were happy with this simple treatment plan, and the team found that their symptoms significantly improved after only one month of treatment, without any sort of side effects.

PEMF was able to strongly reduce prostate volume after just 28 days of therapy, resulting in a median decrease of 5.4%. Symptoms also improved, with high compliance and no effects on hormonal and sexual function.

There were no differences between subjects who continued therapy for three more months and those who did not, showing that one month of therapy may be sufficient for the device to effectively reduce prostate volume and symptoms.

Patients with moderate-severe lower urinary tract symptoms and without metabolic syndrome (a cluster of conditions that include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels and that increase the risk of heart disease, stroke, and type 2 diabetes) seemed to benefit more from this treatment.

The pilot study provided promising evidence for the usefulness of PEMF to treat BPH. The decrease in prostate size was less than that attained in dogs, however.

This may be due to differences between dogs and humans in the architecture of prostate tissue and growth characteristics due to BPH.

Additional research with a larger number of men and a control group is needed to better understand the optimal schedule and duration of treatment, the impact of treatment on prostate tissue, and the potential use of PEMF in conjunction with traditional BPH therapies.

The lead author of the study is Prof. Andrea Isidori.

The study is published in Andrology.

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