Prostatic artery embolisation
Prostatic artery embolisation (PAE) is a minimally invasive procedure option utilised to treat the benign prostatic hyperplasia (BPH).
PAE has been used for controlling prostatic haemorrhage (such as those associated prostate cancer) since 1970. However, its use in the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hypertrophy in human was first published in 2010 by Carnevale et al 3, following several articles on PAE based on animal studies.
The prostate receives its blood supply from the prostatic arteries, which arise as a single or paired vessels on each side of the pelvis. PAE is usually performed via a single common femoral artery puncture. Super-selecting and embolising the prostatic arteries result in ischaemic necrosis of the gland followed by its shrinkage and subsequent reduction in the symptoms of LUTS.
Recognised complications include:
- groin complications, such as haematoma or femoral artery pseudoaneurysm
- prostate infarction
Symptomatic relief starts to occur within days in most cases of LUTS5, and side effects are generally mild. The typical urosurgical complication such as bleeding requiring transfusion, bladder incontinence, and erectile dysfunction, have not been reported with PAE. Quality of life scores suggest that patients are quite satisfied with their urinary symptoms following the treatment 5.
- 1. Sun F, Sánchez FM, Crisóstomo V et-al. Benign prostatic hyperplasia: transcatheter arterial embolization as potential treatment-preliminary study in pigs. Radiology. 2008;246 (3): 783-9. doi:10.1148/radiol.2463070647 - Pubmed citation
- 2. Jeon GS, Won JH, Lee BM et-al. The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: a pilot study. J Vasc Interv Radiol. 2009;20 (3): 384-90. doi:10.1016/j.jvir.2008.11.014 - Pubmed citation
- 3. Carnevale FC, da Motta-Leal-Filho JM, Antunes AA et-al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol. 2013;24 (4): 535-42. doi:10.1016/j.jvir.2012.12.019 - Pubmed citation
- 4. Camara-Lopes G, Mattedi R, Antunes AA et-al. The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia. Int Braz J Urol. 2013;39 (2): 222-7. Pubmed citation
- 5. McWilliams JP, Kuo MD, Rose SC et-al. Society of Interventional Radiology position statement: prostate artery embolization for treatment of benign disease of the prostate. J Vasc Interv Radiol. 2014;25 (9): 1349-51. doi:10.1016/j.jvir.2014.05.005 - Pubmed citation