Short- to Midterm Safety and Efficacy of Prostatic Artery Embolization: A Systematic Review

To review the available safety and efficacy data for prostatic artery embolization (PAE) in the treatment of benign prostatic hyperplasia (BPH).

PubMed was searched for publications that included PAE for the treatment of BPH through May 2015. Two independent reviewers determined the appropriateness for inclusion of each article and compiled data by using pooled weighted means and standard deviations.

The literature search identified 161 articles, of which 7 studies, with a total of 562 patients, met all inclusion/exclusion criteria. PAEs were performed bilaterally in 85% of patients, unilaterally in 12%, and unsuccessfully in 3%. International Prostate Symptom Score decreased from 24.51 ± 6.12 at baseline to 10.42 ± 5.39 at 6 months. Quality of life score decreased from 4.76 ± 0.98 at baseline to 2.51 ± 1.13 at 6 months. Peak urinary flow rate increased from 8.41 mL/s ± 2.63 at baseline to 15.44 mL/s ± 5.64 at 6 months. Postvoid residual measurement decreased from 105.94 mL ± 76.77 at baseline to 39.57 mL ± 15 at 6 months. Prostate-specific antigen level decreased from 4.79 ng/mL ± 5.42 at baseline to 3.16 ng/mL ± 1.5 at 6 months. None of these parameters showed clinically significant changes from 6 months to 12 months. Total prostate volume decreased from 96.56 cm3 ± 35.47 at baseline to 46.73 cm3 ± 20.51 at 12 months. There were 200 minor complications and 1 major complication.

PAE improves lower urinary tract symptoms caused by BPH, with a favorable short- to midterm safety profile.