Prostatic Arterial Embolization: Post-Procedural Follow-up

• Published in: Techniques in vascular and interventional radiology 2012-12, Vol.15 (4), p.294-299
• Main Authors: Fernandes, Lucia, MD, Rio Tinto, Hugo, MD, Pereira, Jose, MD, Duarte, Marisa, MD, Bilhim, Tiago, MD, PhD, Martins Pisco, João, MD, PhD
• Format: Article
• Language: English
• Subjects: benign prostatic hyperplasia (BPH); Biomarkers - blood; Diagnostic Techniques, Urological; Embolization, Therapeutic - adverse effects; Hematology, Oncology and Palliative Medicine; Humans; Kallikreins - blood; Magnetic Resonance Imaging; Male; Predictive Value of Tests; Prostate - blood supply; Prostate - diagnostic imaging; Prostate - pathology; Prostate-Specific Antigen - blood; prostatic arterial embolization (PAE); Prostatic Hyperplasia - diagnosis; Prostatic Hyperplasia - physiopathology; Prostatic Hyperplasia - therapy; Radiology; Severity of Illness Index; Surveys and Questionnaires; Time Factors; Treatment Outcome; Ultrasonography; Urodynamics
• ISSN: 1089-2516; 1557-9808
• DOI: 10.1053/j.tvir.2012.09.008

Prostatic arterial embolization (PAE) gained special attention in the past years as a potential minimally invasive technique for benign prostatic hyperplasia. Treatment decisions are based on morbidity and quality-of-life issues and the patient has a central role in decision-making. Medical therapy is a first-line treatment option and surgery is usually performed to improve symptoms and decrease the progression of disease in patients who develop complications or who have inadequately controlled symptoms on medical treatment. The use of validated questionnaires to assess disease severity and sexual function, uroflowmetry studies, prostate-specific antigen and prostate volume measurements are essential when evaluating patients before PAE and to evaluate response to treatment. 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 benign prostatic hyperplasia, up to 15% of patients fail to show improvement significantly after PAE, and there is a modest improvement of the peak urinary flow.