In the last weeks two really remarkable papers were published dealing with the Prostate Artery Embolization (PAE) for the treatment of BPH (=Benign Prostate Hyperplasia).
The vast majority of previous publications regarding PAE were published in Interventional Radiology journals since this treatment is performed by Interventional Radiologist – hopefully in close cooperation with urologists. For that reason these two publications are a real milestone in the acceptance of PAE as a treatment alternative to the current goldstandard TURP (=transurethral resection of the prostate) in BPH patients.
The first paper was published in the journal Current Opinion in Urology (Young S, Golzarian J. Prostatic artery embolization for benign prostatic hyperplasia: a review. Current opinion in urology 2018; 28:284-287). This very important urological journal delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. I am very happy that one of the two managing editors of the journal is Prof. Dr. Shahrokh Shariat, the chair of the Department of Urology at the Medical University of Vienna. I definitely hope and think that this fact will have a positive influence on the acceptance of the PAE in Austria. The authors of the present review-paper conclude the following: “Initial data on PAE shows it can provide excellent clinical outcomes with patients experiencing minimal complications. However, more high-quality, high-level data are needed particularly in regards to long-term outcomes to determine durability.”. These conclusions are very important and positive for the future of PAE: 1.) The method works. 2.) The method is save and shows only minimal and rare complications.
Another milestone dealing PAE was published a few days ago by the „National Institute for Health and Care Excellence“ (NICE). This independent institution is a one of the pioneers in quality assessment in healthcare. NICE carries out assessments of the most appropriate treatment regimes for different diseases. This must take into account both desired medical outcomes (i.e. the best possible result for the patient) and also economic arguments regarding differing treatments. The present NICE publication deals with the PAE in all details and presents this method as a minimal invasive and safe treatment alternative in BPH-patients to the current gold-standard TURP (=transurethral resection of the prostate).
A few days after this publication the “Austrian Society of Urology” published a very negative statement regarding PAE in BPH treatment – to sum up: “this method is invasive, not save and can harm the patients”. I will not comment on this article but I really can recommend the reading of it (www.uro.at). It is just amazing and funny – and every reader easily can assess the real motivation of the publication of this article.