Men's HealthBenign Prostatic Hyperplasia:
Navigating an Evolving Therapeutic Landscape
A case-based dialogue on BPH management — examining where PAE fits in the treatment algorithm and what the evidence tells us about patient selection, outcomes, and quality of life.
About This Webinar
Benign prostatic hyperplasia is among the most prevalent conditions in men's health — so common it is almost considered an inevitability of ageing. By the sixth decade, more than half of men are living with the lower urinary tract symptoms it produces: frequency, urgency, incomplete emptying, and the slow erosion of sleep and quality of life that follows. Despite this, BPH management has remained largely formulaic for decades — a stepwise progression through alpha-blockers, 5-alpha-reductase inhibitors, and ultimately TURP. Each step carries trade-offs, and for many patients — particularly those with significant comorbidities or an active sexual life — the standard pathway is neither well-tolerated nor well-suited.
That picture is shifting. Prostatic artery embolisation has emerged as a minimally invasive alternative that challenges where PAE sits in the treatment algorithm — and for whom it may represent a first choice rather than a last resort. Recent randomised evidence, including the PARTEM trial, shows PAE can deliver clinically meaningful symptom reduction that outperforms combined medical therapy at nine months, while preserving sexual function in ways that pharmacological treatment frequently cannot. Yet traditional approaches retain an important role, and the clinical reality is that no single intervention suits every patient.
This session explores that evidence through real cases, with Interventional Radiologist, Dr Gareth Bydawell and Urologist Dr Mike Nicholls, focusing on patient selection, technical decision-making, and the evolving collaboration between urology and interventional radiology in defining what is achievable for each patient.
- Describe the pathophysiology of BPH and the clinical burden of lower urinary tract symptoms, including how symptom severity is assessed using standardised tools such as the International Prostate Symptom Score (IPSS)
- Outline the current stepwise management approach to BPH — from watchful waiting and lifestyle modification through pharmacological therapy to surgical intervention — and articulate the clinical thresholds and patient factors that guide progression along that pathway
- Explain the mechanism, procedural requirements, and patient selection criteria for prostatic artery embolisation, including the characteristics of patients most likely to benefit from a minimally invasive endovascular approach
- Critically evaluate the evidence base for PAE — including comparative data against TURP and combined medical therapy — and identify the clinical contexts in which PAE demonstrates superior outcomes, including in patients for whom preservation of sexual function is a treatment priority
- Apply insights from case-based evidence to clinical decision-making in BPH management, including recognition of cases suited to cross-speciality referral between urology and interventional radiology
Meet the Expert Panel
Two specialists, two disciplines — one shared commitment to advancing how South Africa manages BPH. Click any card to read the full biography.
