Prostatic artery embolization for benign prostatic hyperplasia: a review

Over the last several years prostate artery embolization (PAE) has been developed as a minimally invasive technique for the treatment of benign prostatic hyperplasia induced lower urinary tract symptoms. This review aims to elucidate the data available on this developing technique and identify areas requiring further investigation.

Recent studies have demonstrated that PAE is able to deliver excellent clinical outcomes in terms of International Prostate Symptom Score, quality-of-life score, maximum urinary flow rate, post-void residual, and prostate volume reduction. These outcomes have been accomplished with a very low complication profile. Several authors have also been able to demonstrate good outcomes with PAE in the setting of large prostates, a challenge for some other minimally invasive techniques. However, it is important to note that the majority of studies published have been retrospective in nature, and the two prospective clinical trials have had several weaknesses.

Initial data on PAE shows it can provide excellent clinical outcomes with patients experiencing minimal complications. However, more high-quality, high-level data are needed particularly in regards to long-term outcomes to determine durability.