Cùng với sự tiến bộ của khoa học, ngày càng có nhiều phương pháp điều trị Phì đại tuyến tiền liệt ra đời, trong đó có phương pháp nút động mạch tuyến tiền liệt (PAE- Prostatic Artery Embolization). Cơ chế của phương pháp này là ngăn cản quá trình bơm máu cho tuyến tiền liệt, làm tuyến này không được nuôi dưỡng và tự nhỏ đi. Từ đó, giảm bớt sự chèn ép, kích thích lên cổ bàng quang, giúp đường tiểu thông thoáng, đẩy lùi các triệu chứng lâm sàng (Tiểu khó, tiểu không hết, tiểu nhiều cả ngày lẫn đêm…) và nâng cao chất lượng cuộc sống cho người bệnh.
Phương pháp này là một tiến bộ vượt bậc về can thiệp mạch máu của chuyên ngành Chẩn đoán hình ảnh và đã được dụng rộng rãi tại nhiều nước trên thế giới, đặc biệt ở các nước như Mỹ, Anh, Pháp, Trung Quốc… hiệu quả của kỹ thuật này đã được chứng minh trong nhiều thử nghiệm lâm sàng ngẫu nhiên có đối chứng.
Tại Việt Nam, khoa Chẩn đoán hình ảnh Bệnh viện Bạch Mai đã tiến hành nút động mạch tuyến tiền liệt thành công cho hơn 200 trường hợp với kết quả tốt. Hiện bệnh viện Hữu Nghị cùng với khoa chẩn đoán hình ảnh bệnh viện Bạch mai đã cùng phối hợp triển khai phương pháp điều trị này cho kết quả rất đáng khích lệ.
Ưu điểm và hạn chế của phương pháp nút mạch động mạch tuyến tiền liệt
Theo TS.BS. Nguyễn Xuân Hiền – Phó trưởng Khoa Chẩn đoán hình ảnh, BV Bạch Mai, nút động mạch tuyến tiền liệt có một số ưu điểm như:
- Giải pháp nhanh chóng, không gây đau đớn cho người bệnh
- Người bệnh chỉ phải nằm viện 8 tiếng sau can thiệp
- Kích thước tuyến tiền liệt bắt đầu giảm sau 2 tuần
- Giảm nhanh những khó chịu về đường tiểu, người bệnh đi tiểu êm dịu và dễ dàng hơn
Tuy nhiên, phương pháp này vẫn còn vấp phải một số hạn chế:
- Chí phí thường cao hơn các phương pháp điều trị khác (chi phí cho nút mạch là hơn 20 triệu, nếu có bảo hiểm sẽ được giảm 80% và người bệnh còn phải nộp hơn 4 triệu tiền viện phí… chưa tính các khoản phụ phí bên ngoài).
- Đây là một kỹ thuật khó, đòi hỏi các các chuyên gia có trình độ chuyên môn cao thực hiện, do vậy nó mới được áp dụng ở một số ít bệnh viện như Bạch Mai, Hữu nghị hay 103… đều là những bệnh viện trung ương. Cho nên việc đi lại, cũng như chờ khám sẽ rất lâu và mất thời gian.
- Do đàn ông bị phì đại tuyến tiền liệt thường lớn tuổi, mạch đã bị xơ vữa, mạch nhỏ xoắn nên đưa ống thông vào rất khó khăn. Có thể gặp phải rủi ro vỡ mạch máu và đề lại những di chứng về sau.
- Nhiều chuyên gia nói rằng, phương pháp này không làm ảnh hưởng đến chức năng sinh lý của đàn ông, nhưng thực tế không phải vậy. Khi tuyến tiền liệt bị hoại tử và nhỏ đi sẽ khiến nó mất đi những chức năng quan trọng của mình. Bao gồm chức năng ngoại tiết (đóng góp 30% tinh dịch) và chức năng nội tiết (kích thích ham muốn phái mạnh). Cho nên phương pháp này vẫn ảnh hưởng đến chức năng sinh lý, cũng như chất lượng tinh binh.
Từ những phân tích trên, có thể thấy nút động mạch tuyến tiền liệt là một phương pháp tiên tiến, ít rủi ro hơn các kỹ thuật phẫu thuật trước đây. Nhưng vẫn còn nhiều hạn chế về chi phí, cùng các biến chứng đi kèm. Do vậy, độc giả nên cân nhắc thật kỹ, đánh giá lợi hại và tham khảo ý kiến của chuyên gia trước khi quyết định giải pháp này.
TKS Tiền Liệt Tuyến
Bài viết đã được soạn thảo, kiểm tra và phê duyệt bởi đội ngũ bác sĩ, dược sĩ , giáo sư từ Viện Y Học Bản Địa Việt Nam với đại diện là Bác sĩ Hoàng Sầm – Chủ tịch Viện, phó chủ tịch hội Nam Y Việt Nam.
Hỏi đáp cùng bác sĩ Giải đáp trực tiếp
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