Prostate artery EmbolisAtion Safety and efficacY: Preliminary and foLlow-Up urodynamic Studies (P-EASY PLUS)

To assess the efficacy of prostate artery embolisation (PAE) in the management of obstructive benign prostatic hyperplasia (BPH) by conducting formal urodynamic studies.

Patients with symptomatic BPH underwent baseline assessments, including urodynamic evaluation, followed by PAE. Follow-up International Prostate Symptom Scores (IPSS), Quality of Life questionnaire (QoL) scores, prostate volume and urodynamic variables were assessed at a mean follow-up of 18 months.

A total of 105 patients underwent PAE, with average final follow-up at 18 months. Prostate volumes reduced by a mean of 30.6% and significant improvements were identified across all IPSS parameters (total IPPS decreased by 55%; P < 0.001), QoL scores (improved by 65.9%; P < 0.001), maximum urinary flow rate (increased by 5 mL/s; P < 0.001), postvoid residual urine volume (decreased by 24%; P = 0.049), detrusor pressure (decreased from 65.0 to 48.9 cmH₂O; P < 0.001) and bladder obstruction rates. Bladder obstruction decreased from 66.7% to 29.8% of patients following embolisation. Results were found to be positively correlated to the absolute amount of embolic material injected during the embolisation procedure. PAE was well tolerated, with expected post-embolisation symptoms resolving completely after a mean (sd; range) of 7 (±5; 1-28) days. There were no major procedural complications, no reported urinary incontinence, and new retrograde ejaculation occurred in 2%.

In this study, PAE resulted in statistically significant improvements by both subjective and objective measures, including symptom severity, quality of life and urodynamic parameters. Whilst longer-term studies are required, these findings support PAE as a non-surgical option within the treatment algorithm for managing symptomatic, obstructive BPH.