Prostate Artery Embolization

Benign prostatic hyperplasia (BPH) is characterized by the enlargement of the prostate gland, and affects a significant portion of older men, becoming more prevalent with increasing age. BPH and prostate gland size are influenced by hormones including testosterone and dihydroxytestosterone and has been associated with risk factors such as higher androgen levels and family history. Clinically, BPH leads to bladder outlet obstruction and lower urinary tract symptoms (LUTS) including urinary frequency and hesitancy, nocturia, urinary retention, and incomplete voiding. The International Prostate Symptom Score (IPSS) is commonly used to assess LUTS severity. Treatment options depend on symptom severity. Medical therapy, such as 5-α-reductase inhibitors and α-1 blockers, is recommended for mild to moderate cases. Surgical and minimally invasive procedures, like transurethral resection of the prostate (TURP), are reserved for more severe cases. Prostate artery embolization (PAE) is a minimally invasive option, involving selective catheterization and embolization of prostatic arteries. Studies have shown its effectiveness in reducing prostate volume and improving LUTS. It is considered an acceptable treatment option for appropriately selected men with moderate to severe BPH. PAE offers advantages like faster recovery and fewer complications compared to TURP, especially for larger prostates. It is also cost-effective, making it a viable alternative for patients with medically refractory BPH.