Comprehensive Review on Current Controversies and Debate in Prostate Artery Embolization

Prostate artery embolization is emerging as one of the most effective therapies amidst a new era of mini- mally invasive benign prostate hyperplasia treatment and technology. However, several current controver- sies remain unanswered which could impact the widespread adoption of this novel and unique transarterial(rather than transurethral) intervention. This is reflected in the differences between the UK (NICE), European (EAU), and American (AUA) guidelines, the latter of which only recommends the use of prostate arteryembolization in a clinical trial setting. The main issues include questions over the duration of symptom response, cost-effectiveness, mechanism of action, patient selection, and other procedural technical consid- erations. These factors are the most pressing faced by proponents of prostate artery embolization, and we seek to highlight why their resolution is important to ensure men with benign prostate hyperplasia seeking a minimally invasive solution are optimally informed and most effectively managed.