title: Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale.
abstract: Rationale of prostatic artery embolization (PAE) in the treatment of symptomatic benign prostatic hyperplasia is conventionally believed to include two parts: shrinkage of the enlarged prostate gland as a result of PAE-induced ischemic infarction and potential effects to relax the increased prostatic smooth muscle tone by reducing the number and density of α1-adrenergic receptor in the prostate stroma. This review describes new insights into the likely mechanisms behind PAE, such as ischemia-induced apoptosis, apoptosis enhanced by blockage of androgens circulation to the embolized prostate, secondary denervation following PAE, and potential effect of nitric oxide pathway immediately after embolization. Studies on therapeutic mechanisms in PAE may shed light on potentially new treatment strategies and development of novel techniques.
authors.affiliation: Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km. 41.8, 10071, Cáceres, Spain. feisun@ccmijesususon.com.
authors.forename: Fei
authors.initials: F
authors.lastname: Sun
authors.affiliation: Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km. 41.8, 10071, Cáceres, Spain. crisosto@ccmijesususon.com.
authors.forename: Verónica
authors.initials: V
authors.lastname: Crisóstomo
authors.affiliation: Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km. 41.8, 10071, Cáceres, Spain. cbaez@ccmijesususon.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Báez-Díaz
authors.affiliation: Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km. 41.8, 10071, Cáceres, Spain. msanchez@ccmijesususon.com.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Sánchez
mesh_terms: D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D011467:Prostate / Q000098:blood supply* / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Apoptosis; Benign prostatic hyperplasia; Denervation; Lower urinary tract symptoms; Prostatic artery embolization