The complete anatomy of the prostatic artery: a meta-analysis based on 7421 arteries with implications for embolization and urological procedures

Folia Morphol (Warsz). 2023 Dec 11. doi: 10.5603/fm.97797. Online ahead of print.

Abstract

Background: The goal of the present meta-analysis was to offer physicians the most evidence-based data concerning the anatomical characteristics of the prostatic artery (PA).

Materials and methods: Medical databases including PubMed, Scopus, Embase, Web of Science, Google Scholar and Cochrane Library were searched trough. The overall search process was performed in 3 stages.

Results: The results were established based on a total of 7421 arteries. PA was found to originate from an internal pudendal artery with a pooled prevalence of 28.81% (95% CI: 26.23% - 31.46%). Mean diameter of the PA was found to be 1.52 mm (SE = 0.07). . Single PA was found to occur in 76.43% of the patients (95% CI: 60.96% - 89.12%).

Conclusions: In conclusion, the authors of the present study believe that this is the most accurate and up-to-date analysis regarding the highly variable anatomy of the PA. The PA originates most commonly from the internal pudendal artery (28.81%); however, it may also originate from other pelvic arteries, including the middle anorectal or the superior gluteal arteries. Moreover, accessory PAs may occur, yet, a single main PA supplying the prostate gland is most frequently observed (76.43%). The PA may also form anastomoses with the adjacent arteries (pooled prevalence of 45.20%), which may create a complex vascular network in the pelvis. It is hoped that the current meta-analysis may help to decrease the potential complications that may emerge from diverse endovascular and urological procedures.

Keywords: anatomy; embolization; pelvis; prostate; prostatic artery; surgery.