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Prostate artery embolisation for benign prostatic hyperplasia

BMJ 2018; 361 doi: (Published 19 June 2018) Cite this as: BMJ 2018;361:k2537
  1. Ben Challacombe, consultant urologist1,
  2. Tarun Sabharwal, consultant interventional radiologist1
  1. 1Departments of Urology and Interventional Radiology, Guy’s and St Thomas Hospitals NHS Foundation Trust, London SE1 9RT, UK
  1. Correspondence to: B Challacombe benchallacombe{at}

PAE fills a therapeutic niche between medication and surgery

Prostate artery embolisation (PAE) is a new treatment for benign prostatic hyperplasia that has emerged in the past few years as a potential alternative to endoscopic surgical treatments such as transurethral resection of the prostate (TURP).12 The recent UK Register of Prostatic Embolisation (ROPE) study has shown its preliminary safety and efficacy in a multicentre observational evaluation, which also included an indirect comparison with TURP.3 This study follows other small randomised controlled trials suggesting some benefit of PAE over TURP,4 and in a linked article (doi:10.1136/bmj.k2338), a larger trial adds further detail to PAE’s ongoing evaluation.5

PAE involves cannulation and embolisation of the prostatic arteries via access in the groin or arm. Before the procedure, potentially eligible men receive multiparametric, magnetic resonance imaging scanning to rule out malignancy, a contrast CT scan of the prostatic arteries to ensure vessel patency and no contraindications, and sometimes urodynamics to confirm bladder outlet obstruction.

In their randomised, open label non-inferiority …

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