Prostatic Artery Embolization in Non-index Benign Prostatic Hyperplasia Patients: Single Center Outcomes for Urinary Retention and Gross Prostatic Hematuria - Beyond the Abstract

Many authors who have written about Prostatic Artery Embolization (PAE) have focused on comparing PAE to other BPH procedural treatments that are currently available, often reporting data in patients who would also be considered eligible for TURP or other transurethral procedures. We believe that a more realistic and appropriate population to evaluate for PAE are the non-index BPH patients, those with glands too large or comorbidities too severe for standard surgical procedures. These non-surgical candidates typically have few treatment options, and we believe that PAE provides real value by offering these patients a safe and effective treatment that fills a previously unmet need.
 
Review of the available PAE literature reveals few if any series that have reported on as many patients treated with PAE for either hematuria or retention. In our study, we sought to address the subset of non-index BPH patients suffering from retention or with gross hematuria who have glands too large or comorbidities too severe for standard-of-care surgical procedures. When considering this subset of patients, the existing PAE literature is even more sparse. We did not intend to compare our results to TURP, prostatectomy, or HOLEP, but rather to report data for patients who were not even considered candidates for those procedures.
 
We now have over 25 urologists who have referred over 300 patients in what has been a very collaborative PAE effort over the past 6 years, with three of these urologists contributing as co-authors to this manuscript. We have been able to help many more patients than those included in this study, and we hope that being honored with this privilege to report our results in the mainstream urological scientific literature will enable many more patients to benefit from PAE.

Written by: Raj Ayyagari, MD, Assistant Professor of Radiology, Biomedical Imaging; Radiology Director for Male Interventional Health, Yale University School of Medicine, New Haven, Connecticut, USA.

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