From the Guidelines
Pulmonary Artery Embolization (PAE) is not a recommended treatment for Benign Prostatic Hyperplasia (BPH) due to its inferiority to Transurethral Resection of the Prostate (TURP) in improving symptoms and urodynamic parameters. The long-term results of PAE for BPH are limited, and existing studies suggest that PAE is inferior to TURP in terms of symptom improvement and urodynamic parameters 1. While PAE may have some benefits, such as reduced blood loss and shorter hospitalization time, its overall effectiveness is lower compared to TURP.
Some key points to consider when evaluating PAE for BPH include:
- PAE is inferior to TURP in improving symptoms and urodynamic parameters 1
- PAE has a favorable procedural time and retreatment rate compared to TURP, but its overall effectiveness is lower 1
- Other minimally invasive treatments, such as aquablation, may offer better outcomes and fewer complications compared to PAE 1
- Patient selection is crucial, and PAE may not be suitable for patients with severe atherosclerosis or certain anatomical variations
In terms of specific outcomes, PAE is associated with lower rates of blood loss and shorter hospitalization times compared to TURP, but its symptom improvement and urodynamic parameters are inferior. The procedural time and retreatment rate for PAE are favorable, but its overall effectiveness is lower compared to TURP 1. As a result, PAE is not a recommended treatment for BPH, and other minimally invasive treatments, such as TURP or aquablation, may be more effective.
From the Research
Long-term Results of PAE for BPH
The long-term results of Pulmonary Artery Embolization (PAE) for treating Benign Prostatic Hyperplasia (BPH) have been studied in several research papers.
- The studies have shown that PAE is a safe and effective procedure for BPH with good long-term results for lower urinary tract symptoms 2, 3, 4, 5, 6.
- A study published in 2020 found that PAE was associated with significant improvements in International Prostate Symptom Score (IPSS), quality-of-life score, maximum urinary flow rate, and postvoid residual volume, with a mean follow-up of 27 months 2.
- Another study published in 2016 found that PAE was effective in reducing lower urinary tract symptoms and improving urinary flow rate in high-risk patients with BPH, with no major complications reported 3.
- A systematic review published in 2024 found that PAE was comparable to transurethral resection of the prostate (TURP) in terms of reduction in IPSS and quality-of-life questionnaire, with lower complication and adverse event rates 4.
- A study published in 2017 found that PAE had a positive effect on IPSS, quality-of-life, and all objective outcomes in symptomatic BPH, with a medium-term clinical success rate of 81.9% and a long-term clinical success rate of 76.3% 6.
Key Findings
- PAE is a safe and effective procedure for BPH with good long-term results for lower urinary tract symptoms 2, 3, 4, 5, 6.
- PAE is associated with significant improvements in IPSS, quality-of-life score, maximum urinary flow rate, and postvoid residual volume 2.
- PAE is effective in reducing lower urinary tract symptoms and improving urinary flow rate in high-risk patients with BPH, with no major complications reported 3.
- PAE is comparable to TURP in terms of reduction in IPSS and quality-of-life questionnaire, with lower complication and adverse event rates 4.
- PAE has a positive effect on IPSS, quality-of-life, and all objective outcomes in symptomatic BPH, with a medium-term clinical success rate of 81.9% and a long-term clinical success rate of 76.3% 6.
Complications and Adverse Events
- The studies have reported low rates of complications and adverse events associated with PAE, including no urinary incontinence or sexual dysfunction reported 2, 3, 6.
- A systematic review published in 2024 found that the complication and adverse event rates were higher in the TURP group compared to the PAE group (60.6% vs. 35.5%) 4.