Evaluation of the prostatic artery origin using computed tomography angiography

Objectives: Radiological anatomy of the prostatic artery is important for any kind of surgical or interventional procedure related to the prostatic region. The aim of this study was to define prostatic arterial anatomy that is critical for both urologists dealing with prostatic interventions and interventional radiologists dealing with prostatic arterial embolization. Methods: Computed tomography angiography (CTA) is the gold standard for visualizing pelvic arterial anatomy. In this study, morphometric analyses were performed with CTA in 121 patients (41–89 years) retrospectively. The diameters and origins of 242 prostatic arteries were evaluated. Results: Average diameter of the right prostatic artery was 0.9–2.4 mm; in 39% of the patients the artery originated from the inferior vesical artery. The other origin patterns on the right side were the internal pudendal artery (36%), gluteopudendal trunk (7.4%), obturator (5,8%), inferior gluteal (3.3%), middle rectal (0.8%), umbilical (0.8%) and inferior rectal (0.8%) arteries, and the vesical trunk (0.8%). Average diameter of the left prostatic artery was 0.9–2.7 mm; in 36% of the patients the artery originated from the inferior vesical artery. Other origin patterns revealed for the left side were the internal pudendal artery (31%), obturator artery (13%), gluteopudendal trunk (9.1%), vesical trunk (2.5%) and inferior gluteal artery (2.5%). Conclusion: CTA is crucial for better understanding of the prostatic arterial anatomy and preventing the complications in surgical or interventional procedures such as prostatic arterial embolization, especially for atherosclerotic patients. The data obtained in this study is significant for determination of pelvic vascular disorders.

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  • Carnevale FC, Antunes AA, da Motta Leal Filho JM, de Oliveira Cerri LM, Baroni RH, Marcelino AS, Freire GC, Moreira AM, Srougi M, Cerri GG. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol 2010;33:355–61.