Related Experiment Video
Updated: Sep 6, 2025
Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser
Published on: May 5, 2020
Long-Term Outcome of Prostatic Artery Embolization for Patients with Benign Prostatic Hyperplasia: Single-Centre
Tiago Bilhim1,2,3, Nuno Vasco Costa4,5,6, Daniel Torres4,5,6
1Interventional Radiologist, Interventional Radiology Unit, Saint Louis Hospital, R. Luz Soriano 182, 1200-249, Lisbon, Portugal. tiagobilhim@hotmail.com.
Insights
Prostatic artery embolization (PAE) offers lasting relief for benign prostatic hyperplasia (BPH) symptoms. However, re-intervention rates increase significantly over time, reaching over 50% after 10 years.
Area of Science:
- Interventional Radiology
- Urology
Background:
- Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS).
- Prostatic artery embolization (PAE) is an minimally invasive treatment option for BPH.
Purpose of the Study:
- To assess the long-term outcomes of PAE in patients with BPH.
- Evaluate the durability of PAE and identify factors influencing re-intervention rates.
Main Methods:
- A retrospective study of 1072 BPH patients undergoing PAE from 2009-2019.
- Annual follow-up included International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax), and postvoid residual (PVR) volume.
- Kaplan-Meier analysis assessed re-intervention, repeat PAE, and prostatectomy rates.
Main Results:
- Significant long-term improvements in IPSS and QoL were observed.
- Mean prostate volume and PSA showed no significant reduction.
- Urinary flow rate (Qmax) improved significantly, while postvoid residual (PVR) volume showed no significant change.
- Re-intervention rates were 21.1% at 5 years and 58.1% at 10 years.
- Prostatectomy rates reached 11.6% at 5 years and 35.0% at 10 years.
Conclusions:
- PAE provides durable long-term relief for LUTS in BPH patients.
- A substantial proportion of patients require re-intervention or further procedures over time.
- PAE is an effective treatment option, but long-term efficacy and retreatment rates should be considered.
Purpose:
Assess long-term outcomes of prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH).
Materials And Methods:
Single centre retrospective study from 2009-2019 including 1072 patients who received PAE and had available follow-up. Patients were evaluated yearly at 1-10 years post PAE using the International Prostate Symptom Score (IPSS) and quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax) and postvoid residual (PVR) volume. The need for prostatic medication, re-intervention rates, repeat PAE and prostatectomy rates were assessed with Kaplan-Meier survival analysis and compared between different embolic agents using Cox regression analysis.
Results:
Mean follow-up time was 4.39 ± 2.37 years. At last follow-up visit, mean IPSS and QoL improvements were - 10.14 ± 8.34 (p < .0001) and - 1.87 ± 1.48 (p < .0001) points, mean PV reduction was - 6.82 ± 41.11 cm3 (p = 0.7779), mean PSA reduction was - 1.12 ± 4.60 ng/mL (p = 0.9713), mean Qmax increase was 2.72 ± 6.38 mL/s (p = 0.0005), mean PVR reduction was - 8.35 ± 135.75 mL (p = 0.6786). There were 335 patients (31.3%) needing prostatic medication after PAE. Re-intervention rates were 3.4% at 1 year, 21.1% at 5 years and 58.1% at 10 years. Repeat-PAE rates were 2.3% at 1 year, 9.5% at 5 years and 23.1% at 10 years. Prostatectomy rates were 1.1% at 1 year, 11.6% at 5 years and 35.0% at 10 years. No significant differences were found between polyvinyl alcohol particles, Bead Block, Embospheres and Embozenes.
Conclusion:
PAE induces durable long-term LUTS relief, with re-intervention rates of 20% in the first 5 years and 30%-60% > 5 years post-PAE.
