The Society of Interventional Radiology (SIR) has recently released a new Practice Guidance Document on Prostatic Artery Embolization (PAE) for benign prostatic hyperplasia (BPH).
(https://www.jvir.org/article/S1051-0443(26)00782-7/abstract)

A Practice Guidance Document is a document prepared by a professional medical society that summarizes practical approaches and recommendations for clinical practice, based on the latest medical evidence and expert consensus.

The newly released SIR document provides practical guidance based on current knowledge regarding the indications for PAE, patient selection, pre-procedural evaluation, treatment techniques, post-procedural follow-up, safety, and long-term outcomes.

PAE is a minimally invasive treatment for urinary symptoms caused by benign prostatic hyperplasia. In recent years, evidence regarding its treatment outcomes has continued to accumulate.

According to the SIR document, PAE has been shown to improve the International Prostate Symptom Score (IPSS) by approximately 9 to 21 points and the maximum urinary flow rate (Qmax) by approximately 5 to 7 mL/s. It has also been reported that prostate volume and PSA levels decrease by approximately 20% to 40% after treatment. These findings suggest that PAE may help reduce prostate size and improve urinary symptoms.

For patients with urinary retention, the document also indicates that, with appropriate patient selection, approximately 80% to 90% of patients may be able to discontinue catheter use.

In addition, compared with transurethral resection of the prostate (TURP), PAE is characterized by being less invasive and allowing for faster recovery. Although the degree of improvement in urinary flow may be somewhat more moderate, PAE is also associated with a lower impact on sexual function, including a reduced risk of ejaculatory dysfunction.

On the other hand, PAE does not guarantee permanent effectiveness for all patients. Over the long term, symptoms may recur, and additional treatment such as repeat intervention or surgery may become necessary. It has been reported that approximately 20% to 25% of patients may require additional treatment by five years after the procedure.

For this reason, it is important for patients to fully understand both the expected benefits and limitations of PAE before treatment, and to make an appropriate treatment decision in collaboration with urologists.

At V Health Connect, we provide information on PAE as one of the minimally invasive treatment options for benign prostatic hyperplasia. We will continue to support each patient in choosing the most appropriate treatment based on their symptoms, prostate size, lifestyle, and personal preferences.

Medical Supervisor:
Shigeo Ichihashi, MD