The prostate gland is a pyramid-shaped organ that weighs approximately 20 grams and measures 3x4x2 cm. It has three zones - the peripheral zone (70%), central zone (25%), and transitional zone (5-10%). Prostate cancer develops in the peripheral zone, while benign prostatic hyperplasia (BPH) develops in the transitional zone. The prostate receives its blood supply from various arteries, most commonly the internal pudendal artery (34%). Knowing the detailed arterial anatomy is important for procedures like prostate artery embolization (PAE) to treat conditions like BPH and prostate cancer. Imaging tools like CT angiography and cone beam CT can help the interventional radiologist map the arterial supply before

1. PROSTATE ANATOMY
WHAT DO YOU WANT TO KNOW ?
Mohammed ALMoaiqel
King Abdulazizi Medical City
Riyadh
Saudi Arabia

2. Prostate gland is a pyramid organ,
20 gm weight approx. 3X4X2 cm

3. • Peripheral zone 70%
• Central zone 25%
• Transitional zone 5-10%
• Anterior fibromuscular

4. • Prostate CA in PZ
• BPH in TZ
• Chronic Prostatitis in PZ

7. Rastinehad AR, Caplin DM, Ost MC, et al. Selective arterial prostatic embolization (SAPE) for refractory
hematuria of prostatic origin. Urology 2008; 71:181–184.
Nabi G, Sheikh N, Greene D, Marsh R. Therapeutic transcatheter arterial embolization in the management
of intractable haemorrhage from pelvic urological malignancies: preliminary experience and longterm
follow-up. BJU Int 2003; 92:245–247.

12. PROVISO F. C. Carnevale

13. CT ANGIOGRAPHY WITH MIP & VR

14. 25-55 ispilateral oblique vies with
10-20 caudal angulation

15. Foley catheter

16. The inferior vesical artery (white arrows) arises as the second branch and give
branches to the inferior portion of the Foley balloon F. C. Carnevale

17. Prostatic arteries Origin & types of
anastomosis
Origin
• Internal pudendal artery 34%
• Superior vesical artery 20%
• Gluteal-pudendal trunk 18%
• Obturator artery 13%
• Prostatorectal trunk 8%
• Inferior glutaeal artery 4%
• Accessoory pudendal artery 2%
• Superior gluteal artery 1.5%

18. Anastomosis
• Internal pudendal arteries 43%
• Contralateral PAs 18%
• Ipsilateral Pas 13%
• Rectal arteries 14%
• Vesical arteries 11%
• Lateral accessory pudendal arteries 20%
Prostatic arteries Origin & types of
anastomosis

23. Sandeep Bagla,

27. CONCLUSION
Detailed angiographic arterial prostatic supply
are mandatory to be known by the
interventionlist before and during PAE
CT Angio before, ipsilateral view, Foly catheter
and CONE BEAM CT all are useful tools during
PAE