10 - Short-Term Clinical Outcomes Comparison of Microspheres versus N-butyl Cyanoacrylate Glue for Treating Lower Urinary Tract Symptoms with Prostatic Artery Embolization

Purpose: To determine how embolic agent choice of microspheres versus n-butyl cyanoacrylate glue impacts short-term clinical outcomes when treating lower urinary tract symptoms (LUTS) with prostatic artery embolization (PAE).

Materials and Methods: Forty consecutive patients undergoing PAE to treat LUTS using 100-300mm microspheres or n-butyl cyanoacrylate glue by a single operator (13 years’ experience) from December 2023 to July 2025 were retrospectively reviewed. Six patients were excluded (urethral stricture, history of prior PAE, inability to quantify symptoms). Baseline patient age, body mass index (BMI), and prostate volume (PV) were recorded for both microsphere (n=17) and glue (n=17) PAE groups. International Prostate Symptom Score (IPSS) and Quality of Life (QoL) data were then tabulated for baseline and 1-, 3-, and 6-months post-PAE time points. Comparisons used Student’s t-tests and Mann-Whitney U tests. Adverse events grading used Clavien-Dindo classification.{1}

Results: The microspheres group had mean age of 70.2±6.1 years, BMI of 26.2±4.4 kg/m², and PV of 121±59 mL. Baseline characteristics of the glue group were not significantly different, with mean age of 70.3±6.3 years (p=0.94), BMI of 25.4±7.3 kg/m² (p=0.68), and PV of 103±41 mL (p=0.34). All PAE procedures were technically successful. Clinical outcomes data for both groups are shown in Table 1. IPSS and QoL improved substantially and steadily compared to baseline in both groups (p< 0.01 for all), with no differences between groups in IPSS or QoL at baseline or at 1- and 3-month follow-up (p=NS for all). At 6-month follow-up, IPSS trended lower in the microspheres group (IPSS=3 versus 7, p=0.06). Ninety-day adverse events included two grade 2 events in the microspheres group (hematoma, skin ulcer), with three grade 2 urine infections and two grade 3 events in the glue group (necrotic tissue sloughing and closure device failure).

Conclusion: PAE successfully treated LUTS in this study. Microspheres and glue delivered equivalent substantial improvements in IPSS and QoL at 1- and 3-months post-PAE. Mildly enhanced IPSS improvements with microspheres at 6 months are of uncertain significance. Larger scale, longer term studies are needed to further compare clinical durability and adverse events for the two embolic agents.