Prostatic artery embolization

Abstract

Benign prostatic hyperplasia (BPH) affects a significant proportion of men and its prevalence increases with age. Moderate or severe lower urinary tract symptoms (LUTS) caused by BPH will occur in approximately one quarter of men in their 50s and in approximately half of all men 80 years or older. When medical control of symptoms fails, and/or complications occur, transurethral resection of the prostate (TURP) is attempted. Novel minimally invasive techniques (MIT) have been introduced in recent years with the aim of reducing complications, costs, and length of stay, while equaling or bettering the functional outcomes of conventional TURP. Prostatic arterial embolization (PAE) technique has emerged as an interesting approach in the quest for a nonsurgical alternative to standard BPH treatment for patients that do not respond to medical treatment. Although comparative studies are lacking, preliminary results suggest short-term outcomes better than medical therapy but likely inferior to minimally invasive therapy. Long-term outcomes remain unknown and are surely necessary to establish PAE as a standard of care.