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SIR 2025

Embolization

Men's Health

Scientific Session

Session: Prostate 1

Outcomes of Prostatic Artery Embolization following Failure of Prostatic Urethral Lift for Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

Tuesday, April 1, 2025
3:45 PM – 3:54 PM CT
Location: Music City Center, 204
Purpose: We aimed to evaluate improvement in urination, safety, and sexual function in patients undergoing prostate artery embolization (PAE) following failure of prostatic urethral lift procedure (Urolift) for the treatment of lower urinary tract symptoms associated (LUTS) in patients with benign prostatic hyperplasia (BPH).

Materials and Methods: Between April 2012 and February 2023, all patients from a single institution with a history of prior prostatic urethral lift procedure who subsequently underwent PAE for BPH with moderate to severe LUTS were included in this retrospective analysis. We evaluated the baseline demographics, technical success postoperative complications, functional scores (IPSS, QoL, SHIM, and MSHQ-EjD), and post-void residual volume. Paired sample t-tests were used for statistical analysis.

Results: 27 patients were included for analysis with a mean age of 69 years. Technical success was achieved in 25/27 patients (92.6%), with unilateral embolization performed in the remaining two patients (7.4%). There was a significant improvement (p< 0.01) in IPSS scores relative to baseline with a mean decrease of 12.35 (95% CI: [8.2, 15.8]) at 3 months and 5.9 (95% CI: [0.34,11.46) at 12 months post-PAE. There was a significant improvement (p< 0.01) in urinary bother (QoL) scores relative to baseline with a mean decrease of 2.8 (95% CI: [2.1, 3.5]) at 3 months and 1.8 (95% CI: [0.6, 3.0]) at 12 months post-PAE. No significant changes in SHIM score, MSHQ-EjD, or post-void residual volume were identified during follow up. No major adverse events occurred. One patient developed a femoral artery pseudoaneurysm that resolved without intervention.

Conclusion: Prostate artery embolization is associated with significant improvement in IPSS and QOL-Bother at 3 month follow up and is maintained at 1 year follow up in patients who have previously had a urethral lift procedure.