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Prostatic Arterial Embolization for Treatment of Lower Urinary Tract Symptoms Associated with Benign Prostatic Enlargement

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Abstract

Purpose of Review

Prostatic artery embolization (PAE) is an emerging minimally invasive technique for lower urinary tract symptom reduction from benign prostatic hypertrophy (BPH). While the technique is becoming increasingly popular with patients and interventional radiologists, most urologists remain skeptical of the PAE’s long-term efficacy and comparative success to the gold standard transurethral resection of the prostate.

Recent Findings

PAE has been found in multiple meta-analyses to perform similarly to the gold standard transurethral resection of the prostate (TURP) with regard to patient-driven measures like IPSS and IPSS-QoL, while also performing favorably in objective measurements including Qmax and PVR out to at least 12 months post intervention. Furthermore, PAE has a demonstrated shorter hospital length of stay and fewer adverse events when compared to TURP.

Summary

PAE provides patients with an alternative to transurethral options for the management of LUTS in the setting of bladder outlet obstruction. While long-term evidence demonstrating the durability of PAE is still forthcoming, the procedure has been demonstrated to be safe according to multiple meta-analyses. Patients deserve to be counseled on PAE as an alternative to surgery and made aware that while the overall treatment effect may not be as robust or durable, the procedure carries a favorable adverse event profile that is attractive to patients wishing to avoid a trans-urethral approach.

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Authors and Affiliations

  1. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Patrick Curtin

  2. New England College of Osteopathic Medicine, Portland, ME, USA

    Christopher Chang

  3. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA

    Andre Uflacker

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Curtin, P., Chang, C. & Uflacker, A. Prostatic Arterial Embolization for Treatment of Lower Urinary Tract Symptoms Associated with Benign Prostatic Enlargement. Curr Urol Rep 24, 427–441 (2023). https://doi.org/10.1007/s11934-023-01170-9

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