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Updated: Jun 21, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Safety and Clinical Efficacy of Prostatic Artery Embolization in Patients with Indwelling Urinary Catheter for Benign
Jules Pouchot1, Amandine Crombé1,2, Luc Burlet3
1Service de Radiologie et Imagerie Médicale de L'adulte, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux, France.
Insights
Prostatic artery embolization (PAE) effectively removes urinary catheters in men with benign prostatic hyperplasia (BPH). This safe procedure offers good long-term results for elderly, inoperable patients.
Area of Science:
- Interventional Urology
- Vascular Interventions
- Geriatric Urology
Background:
- Symptomatic benign prostatic hyperplasia (BPH) frequently necessitates indwelling urinary catheter (IUC) use.
- Evaluating prostatic artery embolization (PAE) as a minimally invasive option for IUC removal in BPH patients is crucial.
Purpose of the Study:
- To assess the efficacy and safety of PAE for IUC removal in symptomatic BPH patients.
- To identify predictors of successful catheter-free survival post-PAE.
Main Methods:
- Retrospective multicentric study of 140 BPH patients with IUC undergoing PAE.
- Clinical efficacy assessed by trial without catheter (TWOC) success and post-PAE catheter-free survival (PCFS).
- Statistical analyses included Chi-square, Wilcoxon, and Cox regression models.
Main Results:
- PAE achieved initial successful catheter removal (TWOC success) in 80.7% of patients.
- Major complications occurred in only 2.1% of patients.
- Two-year PCFS was 79% in patients with successful TWOC; no independent predictors were identified.
Conclusions:
- PAE is a safe and effective treatment for IUC removal in elderly, inoperable BPH patients.
- The procedure demonstrates good short-term and long-term clinical efficacy.
- PAE offers a viable alternative to long-term catheterization for select BPH patients.
Abstract:
Background/Objectives: This multicentric study aimed to evaluate the efficacy and safety of prostatic artery embolization (PAE) to remove indwelling urinary catheter (IUC) in patients with symptomatic benign prostatic hyperplasia (BPH). Secondary objectives were to identify features associated with post-PAE catheter-free survival (PCFS). Methods: All consecutive patients who underwent PAE for IUC related to BPH with a follow-up of at least 2 years (except for early death) in 6 French University Hospitals were retrospectively included. Clinical efficacy was defined as the removal of the IUC after PAE (through a trial without catheter [TWOC]) and evaluated at regular intervals. Chi-square tests, Wilcoxon tests and multivariable binary logistic regressions were utilized to investigate predictors of TWOC success. Univariable and multivariable Cox regressions were utilized to investigate predictors of PCFS in patients with TWOC success. Results: 140 men with IUC (median age: 82.5 years, interquartile range [IQR] = 73-88.2 years, range: 46-100) who underwent PAE between January 2017 and March 2021 were included. Initial successful catheter removal (TWOC success) following PAE occurred in 113/140 (80.7%) patients, and 3/140 (2.1%) patients encountered major complications. In patients with TWOC success, PCFS at 6 months, 1 year and 2 years were 87.5% (95%CI: 81.4-94.1), 84.4% (95%CI: 77.7-91.7) and 79% (71.3-87.4), respectively. No independent predictive factors for TWOC success and PCFS were identified. Conclusions: PAE should be considered as a safe option with good clinical efficacy in the short and long term for elderly and inoperable patients with IUC due to symptomatic BPH.
