To evaluate the safety and efficacy of cone-beam CT (CBCT) guided prostatic artery embolization (PAE) combined with transurethral resection of the prostate (TURP) compared with TURP alone in the management of large-volume (>80 mL) benign prostatic hyperplasia (BPH).
This retrospective propensity score matched study included 99 patients with large-volume BPH treated between January 2017 and June 2023. Thirty-three underwent CBCT-guided PAE followed by TURP, and 66 underwent TURP alone. Perioperative parameters, complication rates, and functional outcomes-including International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual urine (PVR)-were compared between groups at baseline and at 3, 6, 12, and 24 months after surgery.
The combination group demonstrated significantly shorter operative time (78.9 ± 21.0 vs. 101.4 ± 25.7 min, P<0.001), smaller perioperative hemoglobin decline (10.0 ± 8.6 vs. 15.7 ± 13.3 g/L, P=0.027), shorter bladder irrigation (1.9 ± 0.6 vs. 2.5 ± 0.9 days, P<0.001), and fewer complications (9.1 % vs. 24.2 %, P=0.049). Total hospitalization costs (Chinese Yuan, CNY) did not differ significantly between the two groups (30,231.3 ± 7,946.2 vs.26,514.9 ± 9,954.4, P=0.065). Functional outcomes were significantly better in the combination group from 6 months onward, with lower IPSS and QoL scores, higher Qmax, and reduced PVR at 6, 12, and 24 months (P<0.05).
CBCT-guided PAE combined with TURP is a safe and effective strategy for large-volume BPH, providing reduced perioperative morbidity and sustained long-term improvements in urinary function compared with TURP alone.
Clinical radiology. 2026 Jan 30 [Epub ahead of print]
Y Yin, M Li, J Wang, T Huang, J Yang, Z Li, X Zhu, C Ni
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China., Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China., Department of Interventional Radiology, Changshu First People's Hospital, Changshu, Jiangsu, China., Department of Interventional Radiology, Nantong First People's Hospital, Nantong, Jiangsu, China., Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address: .