Draft:Prostatic artery embolization

Prostatic artery embolization (PAE) is a non-surgical technique for treatment of benign prostatic hyperplasia (BPH). The treatment involves embolization of prostatic artery branches in order to decrease the size of the prostate gland. The aim of PAE is to provide symptomatic relief of lower urinary tract symptoms and improve quality of life. Although there is increasing data to support PAE, use of the technique remains at an incipient stage.

Men with an enlarged prostate may suffer from symptoms of lower urinary tract obstruction, such as sensation of incomplete urination, inability to urinate, or having to urinate frequently (often awakening from sleep). If symptoms cause significant disruption to a man's quality of life, he may be treated by oral medicines, such as alpha-1 receptor blockers, 5-alpha-reductase inhibitors, or phosphodiesterase-5 enzyme inhibitors.

Men with severe/progressive symptoms or those who do not respond to medication may be considered for surgical intervention, with transurethral resection of the prostate or TURP being the standard of care. Prostate artery embolization represents an alternative, less invasive technique to achieve a similar effect of reduction of prostate volume.

Research on PAE has been underway since 2000. Prospective trials with small numbers of patients, up to approximately 200 patients/trial, have been carried out internationally. Results show that PAE evidence of decreases prostate gland size, prostate specific antigen level, peak urinary flow, post-void residual, and subject urinary symptoms.

There are known complications from PAE procedure, the most common of which include acute urinary retention, rectal bleeding, pain, blood in the urine/sperm, and urinary tract infection. Serious complications are uncommon, and include arterial dissection, bladder wall ischemia.