A 75-year-old artist living in Guatemala, identified as Freed III, traveled to Vietnam to receive treatment for a severely enlarged prostate after years of persistent symptoms and unsuccessful medical therapy.
Freed had lived with benign prostatic hyperplasia for more than two decades, experiencing chronic bladder pain, frequent urination, nocturia, weak urinary flow, and insomnia. Over time, his condition became refractory to medication, significantly affecting both his personal life and professional activities. "At times, I had to urinate every 20 minutes, which was truly disruptive," he said.
As symptoms progressed, Freed reduced his performance schedule and sought treatment abroad, eventually choosing Hong Ngoc General Hospital in Vietnam after researching international medical centers.
Computed tomography scans revealed that Freed's prostate weighed approximately 245 grams, around ten times the normal size of 20–25 grams. The enlarged gland compressed the bladder, reduced functional capacity, and caused continuous irritation, explaining the persistence and severity of his symptoms.
According to Dr. Do Huy Hoang, MD, MSc, a resident doctor in the Interventional Radiology and Diagnostic Imaging Department at Hong Ngoc General Hospital, the condition carried a risk of recurrent urinary tract infections that could progress to urinary stones and kidney damage if left untreated. He recommended prostatic artery embolization (PAE), a minimally invasive procedure suited to large prostate enlargement and aligned with the patient's preference to avoid surgery.
"This was a case of giant prostatic enlargement, which significantly limited treatment options. Prostatic artery embolization provided effective management while preserving the prostate," Dr. Hoang said.
PAE is an endovascular procedure that does not require open surgery or general anesthesia. Through a small catheter inserted via the femoral artery, embolic materials are delivered into the arteries supplying the prostate, reducing blood flow and allowing the gland to shrink gradually over time. The procedure is often considered for elderly patients or those with significant comorbidities.
At Hong Ngoc hospital, the intervention was supported by a digital subtraction angiography system and on-table cone beam computed tomography, enabling detailed visualization of the prostate's arterial supply and precise catheter guidance.
To enhance treatment effectiveness, Dr. Hoang used two internationally standardized embolic materials. Microspheres were applied to achieve deep tissue penetration and volume reduction, while biological glue ensured permanent arterial occlusion to prevent recanalization.
"The embolization was selective and complete, while arteries supplying surrounding organs such as the penis, rectum, and muscles were preserved," Dr. Hoang said. The patient reported no post-procedural pain or bleeding and was discharged two days later.
Two months after the procedure, Freed reported a significant improvement in symptoms. "I feel like I'm living in a new body," he said, adding that he could perform and travel without constant concern about urinary urgency.
Freed said his decision to seek treatment in Vietnam was influenced by positive outcomes reported by other international patients and by consultations with imaging specialists at the hospital.
Vietnam has been attracting a growing number of international patients, with around 300,000 seeking medical care each year, according to the Ministry of Health. This growth has been supported by investment in medical technology, specialized training, and service quality improvements.
Hong Ngoc General Hospital's Diagnostic Imaging and Interventional Radiology Department holds accreditation from the Australian Council on Healthcare Standards (ACHS International), reflecting its capacity to perform complex procedures such as prostatic artery embolization with minimal invasiveness and reduced recovery time.
