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Updated: Sep 21, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients
Iñigo Insausti1, Arkaitz Galbete2, Vanesa Lucas-Cava3
1Department of Interventional Radiology, Hospital Universitario de Navarra, Pamplona, Spain. insausti00@hotmail.com.
Purpose:
To evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).
Materials And Methods:
This multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien-Dindo classification.
Results:
Technical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P < .01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P < .01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P < .05) at 12 months. Minor complications (Clavien-Dindo grades I-II) occurred in 13.6% of patients, without major complications observed.
Conclusion:
PAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcomes.
Insights
Prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) effectively treats benign prostatic hyperplasia (BPH) symptoms. This safe procedure significantly improves urinary function and quality of life in patients with lower urinary tract symptoms.
Area of Science:
- Interventional Radiology
- Urology
- Medical Devices
Background:
- Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS).
- Traditional BPH treatments have limitations and potential side effects.
- Prostatic artery embolization (PAE) offers a minimally invasive treatment option.
Purpose of the Study:
- To assess the safety and efficacy of PAE using polyethylene glycol microspheres (PEGM) for LUTS due to BPH.
- To evaluate subjective and objective outcomes following PAE.
- To document complication rates associated with PEGM-PAE.
Main Methods:
- A multicentric prospective study included 81 patients undergoing PAE with 400 ± 75 µm PEGM.
- Evaluated outcomes included IPSS, QoL, IIEF, Qmax, PVR, VAS, satisfaction, prostate volume, and PSA.
- Complications were classified using the modified Clavien-Dindo system.
Main Results:
- Technical success was achieved in 100% of patients; clinical success in 78.5%.
- Significant improvements observed in IPSS (20.14 to 5.89) and QoL (4.8 to 0.63) at 12 months (P < .01).
- Qmax increased by 114.9% (to 14.2 mL/sec) and PVR decreased by 58% (P < .05). Minor complications (13.6%) with no major events.
Conclusions:
- PAE with PEGM is a safe and effective treatment for symptomatic BPH.
- The procedure leads to significant improvements in both patient-reported symptoms and objective urinary flow parameters.
- PEGM-PAE demonstrates a favorable safety profile with a low rate of minor complications.
