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For John Apple, a prostate artery embolization (PAE) relieved symptoms caused by benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. Image by Evan Lewis

Conway Man Grateful For New Approach to Prostate Problem

Aug. 25, 2023 | The future was anything but hopeful for John Apple, 70, a retired corporate accountant from Conway.

Diagnosed in 2021 with benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, Apple was told by his physician that he had only two treatment options: a surgical procedure that could likely have little effect on his condition or wearing a catheter the rest of his life.

“He didn’t think the surgery would be successful, so he gave me a big box of catheters,” said Apple, who found the process of using a catheter difficult and painful. “I found myself going back to the doctor’s office every six to eight weeks to have it replaced; I had an ongoing appointment with him for 17 months.”

An enlarged prostate can block the flow of urine out of the bladder, leading to many urinary symptoms and potentially urinary tract infections. It is a very common problem, affecting 50% of men over the age of 50.

After using a catheter for several months, Apple found himself with a new medical issue, a lump in his pelvic region. After being seen by Mary Katherine Rude, M.D., a UAMS hepatologist who ordered a biopsy on the growth, Apple found himself in the office of Robert Dixon, M.D. Dixon, who joined UAMS’ Division of Interventional Radiology in 2022, performed the biopsy on the growth, which turned out to be benign. He also talked to Apple about his prostate and his issue with catheters.

A specialist in prostate artery embolization (PAE), a minimally invasive treatment that helps improve lower urinary tract symptoms caused by BPH, Dixon told Apple that he was a potential candidate for the procedure.

PAE is performed through a small puncture in the groin. A catheter is inserted through the artery and directed toward the prostate. Once the catheter is positioned in the artery supplying blood to the prostate, tiny particles are injected that plug up the artery, blocking blood flow. The process is then repeated on the other side, most commonly through the same original puncture.

“He said if I was interested in pursuing that procedure to give him a call, so I did,” said Apple.

“An enlarged prostate is often treated with medications initially. If medications are no longer helping, or if they cause unwanted side effects, PAE is wonderful alternative to the traditional surgical treatment options,” said Dixon, noting the outpatient procedure has a great success rate and a quick recovery period of just a few days.

“Patients like Mr. Apple can often get their catheter removed in just a few weeks, and patients without a catheter will start to notice improvement after just a couple weeks. It is an incredibly rewarding procedure to perform, and I am delighted to be building this part of my practice here in Little Rock,” he added.

After undergoing the PAE in September, Apple experienced considerable relief of his urination issues and no need for a catheter.

“I was shocked that it worked so quickly, I was very grateful to Dr. Dixon,” said Apple, the first patient at UAMS to undergo the procedure. “More men need to know about this, that there’s something out there that can relieve them of this problem.”

As surprising as his results were, Apple said he may have one more surprise for Dixon.

“He told me that the surgery would be good for seven to 10 years and, that at my age, it would probably last me the rest of my life,” said Apple with a laugh. “But I might surprise him and outlive it and have to have it done again.”