Prostate Artery Embolization Shown to be Effective as a Long-Term Treatment for BPH

March 1, 2023—The Society of Interventional Radiology (SIR) announced findings from a new study that demonstrated that prostate artery embolization (PAE) provides long-term effectiveness in treating urinary symptoms caused by benign prostate hyperplasia (BPH). In the long-term North American study, 1,000 patients who underwent PAE for BPH reported significant sustained relief for up to 6 years from lower urinary tract symptoms (LUTS) or urinary retention.

“Prostate Artery Embolization—Single-Center Experience of 1,000 Patients with Short-, Mid-, and Long-Term Follow Up" by Andrew Richardson, MD, et al will be presented by the study’s senior investigator, Shivank Bhatia, MD, at the SIR annual scientific meeting held March 4-9 in Phoenix, Arizona.

“Our study shows that PAE is a highly effective treatment whose long-term outcomes include sustained LUTS relief and significant improvement in quality of life,” commented Dr. Bhatia in the SIR press release. “Of 18 million men in the United States eligible for BPH treatment, many avoid all treatments because of the widely known risks of surgery, particularly sexual side effects and leakage. PAE avoids these risks while achieving long-term positive clinical outcomes.” Dr. Bhatia is Chair of Interventional Radiology at the University of Miami Miller School of Medicine in Miami, Florida.

As summarized in the SIR press release, patients in the study reported dramatic improvements on the 35-point International Prostate Symptom Score ranking symptoms as mild, moderate, or severe.

Preprocedure, patients reported a mean score of 23, in the “severe” range. In < 3 months, patients achieved a score of 6, with “mild” symptoms persisting throughout the 6-year study. This response is similar to that after more invasive surgical options for BPH; however, PAE did not negatively impact sexual function and there was no reported incidence of leakage after PAE.

Study participants were also asked a quality-of-life question: “If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?”

Preprocedure, the mean score was 5 or “mostly dissatisfied.” Within a year, the score was 1, or “mostly satisfied,” a score that also continued through 6 years.

SIR noted that PAE has established a safety profile in repeated studies in the 10 years since it was first used. However, interventional radiologists say most men are unaware of this treatment option. Most men will avoid surgery and may instead take medication for years, even as BPH worsens, potentially leading to bladder failure.

The study also showed a persistent, years-long reduction in prostate size. But as Dr. Bhatia noted, prostate size reduction is not the only goal for long-term effectiveness. He stated, “Treatment should make the prostate softer as well as smaller—as opposed to smaller but remaining hard, which will still cause urinary symptoms.”

Dr. Bhatia, who was the treating physician for all the patients in the study, encourages patients to learn about all options for enlarged prostate symptoms, talk to various physicians, and then decide what’s best for them.

He concluded in the SIR press release, “One size does not fit all when it comes to treating BPH, and PAE remains a very attractive alternative for patients with larger glands and in the setting of acute urinary retention.”

Dr. Richardson, who is a senior resident at Jackson Memorial Hospital in Miami, Florida, added, "Patients choose PAE to avoid the side effects of current medications for BPH, which can include erectile dysfunction, painful or difficult urination, constipation, dizziness, or fatigue. Prostate artery embolization is an alternative not just to surgery but also to lifelong medication.”