Prostatic Artery Embolization: A Non-surgical Treatment for Chronic Prostatitis/Chronic Pelvic Pain from Radiation-Induced Prostatitis

Prostatic artery embolization (PAE) has been found to be effective for the treatment of lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) in men. Moffitt is one of only a few high volume centers in the country to offer PAE therapy and is one of the only locations in the United States to study PAE therapy for patients with cancer under protocol. 

Prostatic artery embolization is a relatively recent therapeutic advancement and is currently used for patients with LUTS from BPH, with recent expansion into other GU indications. Moffitt Interventional Radiologist, Nainesh Parikh, MD, MBA recently published findings showing clinical improvement following treatment with PAE in a case series of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) occurring after radiation therapy for localized prostate cancer. Read more here or download the PDF.

How the procedure treats LUTS and recalcitrant CP/CPPS

PAE is a minimally invasive therapy for men with BPH and LUTS. The premise underlying its efficacy is necrosis of the central gland secondary to hypoxia resulting in decreased urethral pressure.

In patients who have radiation therapy for localized prostate cancer, chronic GU toxicities can reach 30% often resulting in CP/CPPS. In addition, standard therapies for CP/CPPS (often termed the “3 As” of antibiotics, alpha blockers and anti-inflammatories) are only 50% successful. Several novel therapies have been studied for CP/CPPS after radiation, with limited success. PAE has recently been shown to result in successful (up to 90%) improvement of clinical symptoms and QoL (80%) in this patient population. 

The procedure is performed as an outpatient and involves arterial embolization of bilateral prostatic arteries via transfemoral or transradial approach. Embolization is performed using 300-500 micron microspheres until stasis is achieved. Symptom relief can begin within days after the procedure and patients are followed up at 6 and 12 weeks.

Diagnoses that may benefit from PAE treatment include:

• Benign prostatic hyperplasia (BPH)
• Prostomegaly
• Lower urinary tract symptoms (LUTS)
• Bladder outlet obstruction
• Acute urinary retention
• Foley-catheter dependence
• Hemorrhagic prostatitis
• Radiation-induced prostatitis
• Chronic prostatitis

To refer a patient to Moffitt, complete our online form or contact a physician liaison for assistance or support.  As part of our efforts to shorten referral times as much as possible, online referrals are typically responded to within 24 - 48 hours.