Prostatic Artery Embolization Is Safe and Effective for Medically Recalcitrant Radiation-Induced Prostatitis

Area of Science:

• Urology
• Interventional Radiology
• Oncology

Background:

• Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects many patients post-radiation therapy (RT) for prostate cancer.
• Medical therapies offer limited success, with approximately 50% efficacy and no consistent treatment for refractory cases.
• Prostatic artery embolization (PAE) is established for benign prostatic hyperplasia symptoms.

Purpose of the Study:

• To evaluate the clinical effectiveness of PAE in men with CP/CPPS following RT.
• To report outcomes in a case series of patients with radiation-induced CP/CPPS treated with PAE.

Main Methods:

• Nine male patients (median age 72) with CP/CPPS post-RT underwent PAE.
• Pre-procedure assessment included International Prostate Symptom Score, Chronic Prostatitis Symptom Index, and quality of life (QoL) scores.
• Follow-up at 6 and 12 weeks included symptom scores, QoL assessment, and MRI.

Main Results:

• Technical success (bilateral embolization) was achieved in 78% of patients; unilateral embolization in the remainder.
• No major complications were reported.
• Clinical success was observed in 89% of patients, with 78% reporting improved QoL.

Conclusions:

• CP/CPPS after RT is a debilitating condition with limited success from conventional medical therapy.
• PAE demonstrates potential as an effective treatment option for medically refractory CP/CPPS post-RT.
• Further research is needed to optimize patient selection and treatment protocols for PAE in this context.