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Infections after prostatic artery embolization for benign prostatic hyperplasia: an analysis of the published
Stelios-Elion Bousi1, Konstantinos M Katsikas2, Maria Tsitskari3
1Alfa Institute of Biomedical Sciences, Athens, Greece.
Purpose:
To evaluate the hypothesis that infectious adverse events following prostatic artery embolization (PAE) are comparable to those following other treatment options for benign prostatic hyperplasia (BPH).
Materials And Methods:
A literature review was conducted until August 2025 to identify studies reporting infectious outcomes, including urinary tract infection (UTI), prostatitis, and urosepsis, after PAE for BPH. Both comparative and non-comparative studies, including randomized controlled trials (RCTs), prospective, and retrospective observational designs, were included.
Results:
Thirty-nine studies met the eligibility criteria: 5 RCTs, 14 prospective, and 20 retrospective cohorts. Among comparative studies, the median reported UTI percentage was 3.7% (IQR 1.9%-5%), range 0%-27.5% across 1,722 patients, and 4.8% (IQR 2.7%-27.4%), range 1.6%-36.5% across 11,393 patients who underwent PAE and transurethral resection of the prostate (TURP), respectively. In prospective non-comparative cohorts, the median reported UTI percentage was 3.5% (IQR 1.7%-6.9%), range 1%-13.3% across the 1,172 included patients. Among retrospective non-comparative cohorts, the median reported UTI percentage was 3% (IQR 1.6%-4.3%), range 0.3%-11.8% across the 5,752 included patients. Six non-comparative studies reported infectious adverse events in patients with indwelling catheters. The median reported percentage of infectious adverse events was 5.5% (IQR 2.6%-11.5%), ranging from 1% to 12.7% among the 379 included patients. Specific data on prostatitis and urosepsis were infrequently reported as adverse events across the included studies.
Conclusions:
Infectious adverse events following PAE appear comparable to those observed after comparator procedures such as TURP. Higher infection percentages were observed in subgroups of patients with indwelling catheters.
