Prostatic arterial embolisation for men with benign prostatic hyperplasia: a Cochrane review

Area of Science:

• Urology
• Interventional Radiology

Background:

• Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS) in men.
• Prostatic arterial embolisation (PAE) is an alternative treatment option for BPH.
• Comparing PAE with established surgical procedures is crucial for clinical decision-making.

Purpose of the Study:

• To assess the efficacy and safety of PAE compared to other procedures for treating LUTS in men with BPH.
• Specifically evaluate outcomes of PAE versus transurethral resection of the prostate (TURP).

Main Methods:

• Systematic review including randomised controlled trials (RCTs) and non-randomised studies (NRSs).
• Literature search conducted up to November 2021.
• Data extraction, risk of bias assessment, and meta-analysis using a random-effects model.
• Certainty of evidence (CoE) rated for RCTs and NRSs.

Main Results:

• PAE vs TURP: Little to no difference in urological symptom score improvement (low CoE) and quality of life (low CoE) in short-term and long-term follow-up.
• Very uncertain effects of PAE on major adverse events compared to TURP (very low CoE).

Conclusions:

• PAE demonstrates comparable outcomes to TURP regarding symptom and quality of life improvement for BPH.
• Significant uncertainty remains regarding the comparative safety profile and major adverse events between PAE and TURP.