Cadaveric Specimen Study of Prostate Microvasculature: Implications for Arterial Embolization

Abstract Purpose To describe the prostatic microvasculature anatomy and to measure the diameter of the intraprostatic vessels from human cadaveric specimens. Material and Methods The prostates of 18 white males (35–68 years of age; mean prostate volume, 60.11 mL) were fixed in a solution of phosphate-buffered 10% formaldehyde and processed histologically with hematoxylin and eosin stain, Masson trichrome stain, immune peroxidase, and immunofluorescence. Fluorescence-conjugated antibodies (anti-CD34 and anti-actin smooth muscle) were used to mark the endothelium and the fibromuscular stroma, respectively. Each slide was digitally scanned and photographed under microscopy to measure the intraprostatic arterial diameters using image analysis software. Results In 28 hemipelvises (77.8%) a single dominant prostate artery was found (mean diameter, 1.96 mm). The microvasculature study identified 3 types of intraprostatic arterial distributions: internodal (IT), perinodal (PN), and intranodal (IN). The IT arteries are located at the trabeculae of the hyperplastic stroma between the nodules. The PN arteries were located at the periphery of each hyperplastic nodule before entering into it. The IN vessels were located inside the hyperplastic nodules as terminal arteries to the glands. The mean IT artery diameter was 317 μm (min–max range, 155–555 μm), mean PN artery diameter was 150 μm (min–max range, 59–266 μm), and the mean IN artery was 56 μm (min–max range, 24–104 μm). The diameters of intraprostatic arteries did not correlate with prostate volume (IT arteries, P = .303; PN arteries, P = .686; and IN arteries, P = .413). Conclusions The description of the prostate microvasculature anatomy, as described by this cadaveric study, may provide useful information for prostate artery embolization.