Interventional Radiologists Find Promise in Prostatic Artery Embolization

Prostatic artery embolization may be an effective treatment for benign prostatic hyperplasia for men who may not be able to undergo transurethral resection of the prostate, said researchers at the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco, Calif.

The minimally invasive option to surgery provided good response in volume reduction in prostate size and decrease in urinary tract symptoms among the majority of men in this small study, said Francisco Cesar Carnevale, MD, PhD, professor and chief of interventional radiology at the Hospital das Clinicas Hospital of the Faculty of Medicine at the University of Sao Paulo in Brazil.

The researchers studied 11 men (average age 68.5 years) who suffered with acute urinary retention due to an enlarged prostate (ranging from 30 grams to 90 grams) and who had already received medical treatment. The men all had urethral catheters and were waiting for surgery.

The procedure was performed under local anesthetic, and MRI was used to study the exact anatomy of the patients’ prostate. A one-millimeter diameter microcatheter was introduced into the prostate arteries in order to perform the embolization, which used resin microspheres.

Follow-up ranged from 16 months to 45 months. At one year following treatment, all men reported overall clinical improvement in lower urinary tract symptoms. At final follow-up, there was an overall volume reduction of 30 percent in prostate size. All men also reported a high degree of satisfaction and increased quality of life.

“I saw firsthand how these men responded to treatment,” said Ziv J. Haskal, MD, FSIR, a professor of radiology and surgery at the University of Maryland School of Medicine and editor-in-chief of the Journal of Vascular and Interventional Radiology. Haskal was one of many SIR members to travel to Brazil to learn about the treatment. “With the possibility of faster recovery - on an outpatient basis - and with no bladder catheters, reduced symptoms, improved urination and fewer potential side effects, prostatic artery embolization could signal a bold new change in accepted prostate therapy.”