Arterial Embolization in Benign Prostatic Hyperplasia: Anatomical-Radiological and Clinical Study

Prostatic arterial embolization (PAE) gained special attention in the past years as a potential minimally invasive technique for benign prostatic hyperplasia (BPH). One the most challenging aspects on PAE is identifying the prostatic arteries and defining the pelvic and prostatic radiological anatomy. With Angio CT and Digital Subtraction Angiography it is possible to depict the number of prostatic arteries, their origin, trajectory, termination and anastomoses with surrounding arteries. PAE may be performed safely with minimal morbidity and without associated mortality. The minimally invasive nature of the technique inducing a significant improvement in symptom severity associated with prostate volume reduction and a slight improvement in the sexual function are major advantages. However, as with other surgical therapies for BPH up to 25% of patients fail to improve significantly after PAE, and there is a modest improvement of the peak urinary flow. These considerations and the investigative nature of PAE should be explained to the patient when counseling the procedure. In this manuscript we review our anatomical-radiological and clinical experience on PAE for BPH.