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.
Originally Broadcast 25 June 20261 Level 1 Clinical CPD Point Watch Anytime · Free to Access
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.
This session is now available to watch on demand. Originally broadcast as a live interactive panel on 25 June 2026, the recording captures the full dialogue — designed to generate the kind of cross-speciality conversation that changes practice not just in the interventional suite, but in urology clinics and general medical wards across the country.
Learning Objectives
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
HPCSA Accreditation
1 Level 1 Clinical CPD Point
Certificate issued on completion · Submit directly to HPCSA
References & Further Reading
01
AUA Guideline: Management of LUTS attributed to BPH, amendment 2023/2024; EAU Guidelines on Non-neurogenic Male LUTS, 2026; McConnell JD et al. NEJM 2003 (MTOPS); Roehrborn CG et al. Eur Urol 2010 (CombAT).Access via DecisionPoint IR Reference Library →
02
Altman R et al.Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.BMC Urology. 2024; 24, 22.Access via DecisionPoint IR Reference Library →
03
Bhatia S et al.Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients.Journal of Vascular and Interventional Radiology. 2024; 36, 456–466.Access via DecisionPoint IR Reference Library →
04
Delazar S, Azadnajafabad S, Firouznia K et al.Outcomes of Prostatic Artery Embolization for Treating Benign Prostatic Hyperplasia Symptoms: A Prospective Single-Center Study.Health Science Reports. 2025; 8(3), e70565. doi:10.1002/hsr2.70565PMC11896813 →
05
Fischer H, Suleman F, & Ahmad S.Outcomes of prostate artery embolisation for benign prostatic hyperplasia in 10 cases at Steve Biko Academic Hospital.South African Journal of Radiology. 2019; 23(1). doi:10.4102/sajr.v23i1.1349Access Article (SAJR) →
06
Govedarica S, Raškovic A, Vojinov S et al.Factors Associated with Health-Related Quality of Life in Patients with Benign Prostatic Hyperplasia Undergoing Pharmacological Treatment: A Cross-Sectional Study.Medicina. 2025; 61(12), 2244. doi:10.3390/medicina61122244doi: 10.3390/medicina61122244 →
07
Iossa V, Punzi E, Pandolfo SD et al.Prostate Artery Embolization (PAE) in the Treatment of Benign Prostatic Hyperplasia: A Case Series and Narrative Review.Journal of Clinical Medicine. 2025; 14(11), 3775. doi:10.3390/jcm14113775doi: 10.3390/jcm14113775 →
Park S, Lee KS, Choi M, & Lee M.Factors associated with quality of life in patients with benign prostatic hyperplasia, 2009–2016.Medicine. 2022; 101(36), e30091. doi:10.1097/MD.0000000000030091doi: 10.1097/MD.0000000000030091 →
10
Sapoval M, Thiounn N, Descazeaud A et al.Prostatic artery embolisation versus medical treatment in patients with benign prostatic hyperplasia (PARTEM): a randomised, multicentre, open-label, phase 3, superiority trial.The Lancet Regional Health – Europe. 2023; 31.PMC12155755 →
11
Zubair A, Davis S, Balogun DI et al.A Scoping Review of the Management of Benign Prostate Hyperplasia in Africa.Cureus. 2022; 14(11), e31135. doi:10.7759/cureus.31135doi: 10.7759/cureus.31135 →
Two specialists, two disciplines — one shared commitment to advancing how South Africa manages BPH. Click any card to read the full biography.
Dr Gareth Bydawell
Interventional Radiologist
Lake Smit & Partners, Durban
Webinar 2 · Session Chair
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Dr Mike Nicholls
Urologist
Busamed Gateway & Life Entabeni
Webinar 2 · Panel
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2026 Programme Partner
Boston Scientific
Platinum Sponsor
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