Last updated March 14, 2022

Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

RECOMMENDATIONS

PAE is an acceptable minimally invasive treatment option for appropriately selected men with BPH and moderate to severe LUTS. (B, Strong)
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PAE can be considered as a treatment option in patients with BPH and moderate to severe LUTS who have very large prostate glands (> 80 cm3 ), without an upper limit of prostate size. (C, Moderate)
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PAE can be considered as a treatment option in patients with BPH and acute or chronic urinary retention in the setting of preserved bladder function as a method of achieving catheter independence. (C, Moderate)
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PAE can be considered as a treatment option in patients with BPH and moderate to severe LUTS who wish to preserve erectile and/or ejaculatory function. (C, Weak)
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PAE can be considered in patients with hematuria of prostatic origin as a method of achieving cessation of bleeding. (D, Strong)
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PAE can be considered as a treatment option in patients with BPH and moderate to severe LUTS who are deemed not to be surgical candidates for any of the following reasons: advanced age, multiple comorbidities, coagulopathy, or inability to stop anticoagulation or antiplatelet therapy. (D, )
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PAE should be included in the individualized patient-centered discussion regarding treatment options for BPH with LUTS. (D, Strong)
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Interventional radiologists, given their knowledge of arterial anatomy, advanced microcatheter techniques, and expertise in embolization procedures, are the specialists best suited for the performance of PAE. (D, Strong)
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Recommendation Grading

Overview

Title

Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

Authoring Organization

Publication Month/Year

May 1, 2019

Document Type

Consensus

External Publication Status

Published

Country of Publication

US

Document Objectives

Here we review the updated global experience with PAE and state the joint position and recommendations of SIR, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology with regard to the use of PAE for LUTS secondary to BPH.

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Hospital, Radiology services

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Treatment

Diseases/Conditions (MeSH)

D011467 - Prostate, D006965 - Hyperplasia, D055357 - Uterine Artery Embolization, D004621 - Embolization, Therapeutic

Keywords

Benign Prostatic Hyperplasia, urinary tract, Prostatic Artery Embolization

Source Citation

McWilliams JP, Bilhim TA, Carnevale FC, Bhatia S, Isaacson AJ, Bagla S, et al. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology: Endorsed by the Asia Pacific Society of Cardiovascular and Interventional Radiology, Canadian Association for Interventional Radiology, Chinese College of Interventionalists, Interventional Radiology Society of Australasia, Japanese Society of Interventional Radiology, and Korean Society of Interventional Radiology. J Vasc Interv Radiol. 2019;30(5):627-637.e1.