Study Highlights Efficacy of Prostate Artery Embolization in Small Volume Prostates

A study conducted by M. Mayr, A. Ahmed, J. Pow-Sang, and N. Parikh reveals that prostate size should not be a determining factor against the use of prostatic artery embolization (PAE) in men with small volume prostates. While PAE has been documented to be clinically effective for larger prostates, limited research has focused on its efficacy for smaller sizes, specifically those under 60cc.

Lead author Dr. Nainesh Parikh, an interventional radiologist at Moffitt Cancer Center, emphasized that many oncologic patients experience significant urinary tract symptoms. Addressing these symptoms before radiotherapy is crucial, hence, his team often receives referrals for PAE, even for patients with smaller prostate sizes. "We know that men, especially oncologic patients, have a high amount of urinary tract symptoms, and improving urinary health prior to radiotherapy is paramount," Dr. Parikh stated.

The Moffitt team undertook a retrospective review involving over 100 men with small volume prostates who underwent PAE from 2018 to 2025. They categorized the participants into three groups based on prostate volume: less than 16cc, 20-60cc, and 40-60cc. According to Dr. Maximilian Mayr, who will present this study at SIR 2026, statistical improvements were observed across all three group categories.

The study reported an approximate clinical success rate of 80% for patients with small volume prostates, which is only slightly lower than the success rates seen in patients with larger prostates. "Even though slightly lower—80% compared to 90%—it still shows that this works. And it means that there is an excellent opportunity to perform a PAE without impacting the bladder neck, penial urethra, or prostatic urethra," Dr. Parikh noted.

The findings challenge the existing assumption that PAE is effective only for larger volume prostates, establishing its applicability for virtually any patient with a prostate. Dr. Parikh concludes that the clinical data supports offering PAE as a treatment option for men with smaller prostates suffering from lower urinary tract symptoms, regardless of guidelines suggesting otherwise.