SIR 2026 Event

Efficacy of Prostate Artery Embolization in Small Volume Prostates Compared to Large Volume Prostates

Monday, April 13, 2026

3:54 PM - 4:03 PM ET

Location: 717

Presenting Author(s)

Ianto Lin Xi, MD (he/him/his)

IR/DR Resident
Hospital Of the University Of Pennsylvania, Pennsylvania, United States

Author/Co-author(s)

Timothy W.I Clark, MD, FSIR, MS

Professor of Clinical Radiology; Director of Interventional Radiology
University of Pennsylvania; Penn Presbyterian Medical Center, Pennsylvania, United States

Shilpa Reddy, MD

Assistant Professor, IR
Penn Medicine, Pennsylvania, United States

Ansar Z. Vance, MD, MS

Associate Professor
University of Pennsylvania, Pennsylvania, United States

Purpose: To evaluate the safety and efficacy of prostate artery embolization (PAE) in patients with small volume prostates (< 50mL) compared to large volume prostates (≥50mL) for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.

Materials and Methods: This retrospective study analyzed 179 PAE patients treated between 2016-2025. Patients were stratified by baseline prostate volume: small (< 50mL, n=30, mean 38.0mL) and large (≥50mL, n=149, mean 114.1mL). The International Prostate Symptom Score (IPSS) was assessed at baseline and 1-3 months post-procedure. Statistical analysis included paired t-tests for within-group comparisons and unpaired t-tests for between-group differences.

Results: Baseline characteristics were similar between groups (mean age 71.9 vs 72.9 years, p >0.05). Both groups demonstrated significant IPSS improvement: small prostates from 20.9 to 15.0 (5.9-point reduction, p< 0.001) and large prostates from 21.1 to 10.0 (11.1-point reduction, p< 0.001). Large prostates showed significantly greater absolute improvement than small prostates (p< 0.001). Technical success was achieved in all small prostate cases. Mean prostate volume reduction was 8.7% in small prostates compared to 26.8% in large prostates at 3 months.

Conclusion: PAE demonstrates significant symptomatic improvement in small volume prostates with excellent technical success rates. Although absolute IPSS reduction is less pronounced than in larger glands, the clinical benefit remains substantial and statistically significant. These findings support offering PAE to symptomatic patients with small prostates while acknowledging that larger glands may achieve greater symptomatic improvement {1,2}.

Declaration of AI and AI-assisted technologies in the writing process. During the preparation of this work the authors used Anthropic Claude Opus 4.1 and GPT-OSS-20b to assist in chart review and for manuscript drafting. After using this tool, the author(s) reviewed and edited the work and take(s) full responsibility for the content of the publication.