SIR Today
PAE shown safe and effective, regardless of prostate volume
Presentation: Sunday, April 12, at 3 p.m. during the Men’s Health 1 session.
Clinical Efficacy of Prostate Artery Embolization in Men with Small Volume Prostates
M. Mayr, A. Ahmed, J. Pow-Sang, N. Parikh
Prostate size should not be a key barrier to effective prostatic artery embolization (PAE), according to a new study.
While PAE has been demonstrated to be clinically effective for men with large prostates, there has been little published on its efficacy in men with smaller volume prostates, such as those less than 60cc.
“There’s always been a question around the efficacy of PAE in the setting of small volume prostates,” said lead author Nainesh Parikh, MD, MBA. According to the American Urological Association guidelines, PAE is reserved for large-volume prostates—but Dr. Parikh does not believe that volume is a sole barrier, especially in the oncologic setting.
“We know that men, especially oncologic patients, have a high amount of urinary tract symptoms, and improving urinary health prior to radiotherapy is paramount,” he said.
Dr. Parikh, an interventional radiologist at the Moffit Cancer Center, said that his radiation oncologist colleagues will refer numerous patients over for PAE before radiation treatment—even if the patient has a smaller prostate. Dr. Parikh and his team comply, because the procedure works, even if there is a gap in literature.
This gap is what his team set out to fill, recognizing the value of their institute in gathering a large amount of data.
“This is a unique setting, because we do so much in the neoadjuvant and post-radiation space,” Dr. Parikh said. “And the reason that becomes important is because we're probably the only cancer center in the world doing it with a significant amount of frequency.”
Because of their cancer work, the team at Moffit has a significant patient population with small volume prostates. In their study, they conducted a single center, single operator retrospective review of over 100 men with small volume prostates who underwent PAE between 2018-2025.
“We divided everything into three groups, looking at volume size from less than 16cc, 20-60cc and 40-60 cc,” said Maximilian Mayr, DO, MBA, who will present this abstract at SIR 2026. “We found that there were statistical changes within all three groups.”
The data revealed approximately an 80% clinical success rate—which is comparable, though slightly lower than in those patients with enlarged prostates.
“There weren’t a lot of surprises,” said Dr. Parikh. “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.”
According to Dr. Mayr, this data negates the common assumption that PAE only works with a large volume prostate, when it can actually be applied to almost any patient with a prostate.
These results are incredibly important for men with prostate cancer who plan to undergo or who have already undergone radiation therapy, Dr. Parikh said. “If a man has a 40 gram prostate and has bad lower urinary tract symptoms, it's not as though we say, ‘Oh, well, the AUA guidelines say that PAE belongs in a large volume prostate.’ No. Those men should still be helped with a PAE.”
According to Dr. Parikh, it should be simple. “If we can be technically successful, and here we've proven with hundreds of men that the outcomes are still excellent, why wouldn't we do it?”
Related
![]()
Related
![]()
Related