Society of Interventional Radiology (SIR) 2026 Practice Guidance Document for Prostatic Artery Embolization

Area of Science:

• Interventional Radiology
• Urology
• Medical Device Technology

Background:

• Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS) in aging men.
• Prostatic artery embolization (PAE) has emerged as a minimally invasive treatment alternative.
• Significant advancements in evidence and technology have occurred since the 2019 Society of Interventional Radiology (SIR) consensus.

Purpose of the Study:

• To synthesize recent clinical data and technological innovations in PAE.
• To provide updated practice guidance on PAE for BPH management.
• To address patient selection, procedural techniques, and safety based on evidence up to 2025.

Main Methods:

• Analysis of a wide array of published literature up to 2025.
• Inclusion of randomized controlled trials, meta-analyses, retrospective studies, and expert opinions.
• Referencing prior SIR guidelines and international standards for comprehensive guidance.

Main Results:

• PAE is increasingly accepted and incorporated into major urological guidelines.
• Evidence supports PAE as a viable alternative to conventional surgical treatments for BPH.
• The guidance covers comprehensive aspects from patient selection to future research.

Conclusions:

• PAE is a well-established, minimally invasive treatment for BPH-related LUTS.
• Updated guidance ensures optimal patient care and procedural standardization.
• Continued research is essential to further refine PAE applications and outcomes.