Prostatic artery embolization compared to surgical and minimally invasive procedures for treating benign prostatic hyperplasia

According to a recent study, prostatic artery embolization (PAE) has emerged as a viable treatment alternative for patients dealing with symptomatic benign prostatic hyperplasia (BPH) who are not eligible for surgical intervention or have not responded well to medical therapy. Overall, those in the PAE treatment groups experienced fewer adverse events. The results of this study were documented in the publication, BMC Urology.
A systemic literature search was conducted to identify studies published up to August 2021. The search terms utilized were (prostatic embolization or prostate embolization) and (prostatic obstruction or prostatic hyperplasia), along with the abbreviations BPH and PAE. Evaluation of bias was conducted using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials (RCTs). Revman 5.4 was used to perform a random-effects meta-analysis. The analysis included seven studies with a total of 810 patients: 5 RCTs and 1 observational study comparing PAE with transurethral resection of the prostate (TURP), as well as one observational study comparing PAE with open simple prostatectomy (OSP).
TURP and OSP demonstrated greater statistically significant improvements in urodynamic measures and BPH symptoms than PAE. However, PAE appears to significantly enhance erectile dysfunction compared to OSP. PAE seemed to reduce adverse events and report more minor complications compared with OSP and TURP, but its long-term effectiveness remains unclear.
Therefore, PAE has emerged as a viable alternative for managing symptomatic BPH in patients who are not suitable for surgical procedures or have not shown significant improvement with medical therapy. Individuals undergoing PAE treatment have reported fewer adverse events. Continued and longer-term studies are essential to gain a more comprehensive understanding of the benefits of PAE in comparison to other treatment modalities.