Prostate Artery Embolization Shown to Be Effective for Benign Prostatic Hyperplasia in Study Presented at SIR

March 2, 2015—The Society of Interventional Radiology (SIR) announced that a retrospective study of treating benign prostatic hyperplasia (BPH) using prostate artery embolization (PAE) demonstrated that clinicians were able to improve patient symptoms, regardless of the size of BPH before the treatment. The study’s Lead Investigator is Sandeep Bagla, MD, an interventional radiologist at Inova Alexandria Hospital in Alexandria, Virginia. SIR 2015, the society’s 40th annual scientific meeting in Atlanta, Georgia, is featuring the study.

In the SIR press release, Dr. Bagla commented, “As health care moves toward more patient-centered care, it’s critical that interventional radiologists, in collaboration with urologists, are able to provide BPH patients with a relatively painless, outpatient procedure. This innovative treatment offers less risk, less pain, and less recovery time than traditional surgery, and we are hopeful that further research will confirm it to be an effective therapy for BPH.” 

As summarized in the release, the investigators examined the cases of 78 patients who underwent PAE for BPH as part of the clinicians’ routine practice. Patients were categorized into three different analysis groups based on the size of the enlarged prostate: < 50 cm³, between 50 and 80 cm³, and > 80 cm³. The investigators evaluated the effectiveness of PAE in these patients at 1, 3, and 6 months posttreatment.

The investigators reported that 96% of cases (75 of 78) were considered technically successful, with both blood vessels leading to the enlarged prostate blocked by PAE treatment. Symptom improvement and quality of life, as measured by the American Urological Association Symptom Index, significantly improved in all three patient groups. When comparing each group, there was no difference in outcomes as well. Using the International Index of Erectile Function, patients also did not report a change in their sexual function. Dr. Bagla attributes this low rate of side effects to the fact that PAE is conducted via the femoral artery versus other treatments, which enter through the urethra or penis, advised SIR.

Dr. Bagla explained, “Many men have BPH that cannot be treated by traditional methods, such as when the BPH is smaller than 50 cm³ or larger than 80 cm³. PAE offers these patients an effective treatment that results in reduced risk of bleeding, urinary incontinence, or impotence compared to other BPH therapies, offering patients a better quality of life.”

Dr. Bagla noted that although the data from this research demonstrate continued symptomatic improvement 6 months after treatment, more research is needed to show efficacy at 2 years and beyond. He advised that additional research—possibly randomized, prospective studies—should be conducted to compare the safety and efficacy of PAE with other commonly performed BPH treatments.

The SIR.15 abstract 298 study, “Comparative study of PAE in small volume (< 50 cc), midsize (50–80 cc) and large volume (> 80 cc) benign prostatic hyperplasia: feasibility, safety and clinical efficacy,” is available online.

For a more in-depth look at PAE and the results of this study, please see the upcoming interview with Dr. Bagla in our April edition focusing on embolization.