What are the long-term effects of prostatic artery embolization on benign prostatic hyperplasia?

This study aimed to investigate the long-term effects of prostatic artery embolization (PAE) in benign prostatic hyperplasia. The main finding was that PAE was a safe and effective long-term treatment.

Benign prostatic hyperplasia (BPH) is a non-cancerous condition in which the prostate gland is larger than usual. Associated symptoms may include urinary incontinence and more frequent urination.

Prostatic artery embolization (PAE) may be useful to treat BPH. PAE is performed through a small catheter inserted into the artery in your wrist or groin. This is guided into the vessels that supply blood to the prostate. An X-ray in which dye is injected into the blood vessels) is done to map the vessels around the prostate. Tiny round particles are injected through the catheter and into the blood vessels to reduce its blood supply with the aim of reducing the size of the prostate. The long term safety and effectiveness of PAE in BPH remain under investigation.  

This study evaluated the health records of 317 patients with moderate to severe BPH symptoms. All patients received PAE. Patient follow-up was for 3-96 months. International Prostate Symptom Score (IPSS; a questionnaire used to evaluate the severity of urinary tract symptoms), quality-of-life score, maximum urinary flow rate, the volume of urine left in the bladder after urination, prostate-specific antigen (PSA; a protein which is often increased in BPH), and prostate volume were assessed.

Treatment resulted in a 39% reduction of prostate size after an average of 27 months. Symptoms returned in 23% of men, on average of 72 months after treatment. After treatment, the IPSS and quality-of-life score improved.  Men with a higher PSA level before treatment were less likely to experience symptoms coming back.

Most side effects such as short-term bloody urine and semen, urinary tract infections, and pain while urinating were mild. None of the patients experienced urinary incontinence (urine leakage) or erectile dysfunction (inability to obtain and maintain an erection firm enough to have sexual intercourse) at any time during follow-up.

This study suggested that PAE was safe and effective as a long-term treatment for BPH.

This study only included patients treated in one hospital. Therefore the results may not be applicable to patients treated elsewhere.

If you have questions about the treatment of BPH, please consult your doctor.