Impact of High Baseline Postvoid Residual Volume on Outcomes Following Prostatic Artery Embolization

This single-center retrospective study evaluated whether elevated baseline postvoid residual (PVR) volume is associated with reduced prostatic artery embolization (PAE) durability. Of 573 PAE procedures performed from 2015 to 2023, 176 patients who fit the inclusion criteria were included in the analysis. They were stratified by baseline PVR of ≥300 mL (n = 25) versus <300 mL (n = 151). The primary outcome was a composite of subsequent prostate surgery and/or need for indwelling urinary catheter. Secondary outcomes were changes in International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, and PVR at 3-6 and 12 months. After inverse probability of treatment weighting, composite endpoint risk was higher in the PVR ≥ 300-mL group (38.7% vs 11.3%; risk ratio, 3.43; 95% CI, 1.76-6.70; P = .0003), whereas IPSS and QoL improvements were similar. Patients with baseline PVR ≥ 300 mL experienced comparable early symptomatic improvement after PAE but had a higher observed risk of later surgery or recurrent catheter placement.