Study finds that while prostatic artery embolization (PAE) shows promise for symptomatic benign prostatic hyperplasia (BPH) patients not suitable for surgery, transurethral resection of the prostate (TURP) and open simple prostatectomy (OSP) demonstrate more significant improvements in urodynamic measures and BPH symptoms.

The following is a summary of “Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and Meta-analysis,” published in the January 2024 issue of Urology by Altman et al.

This study presents a comprehensive systematic review and meta-analysis comparing the effectiveness of prostatic artery embolization (PAE) with traditional treatments, transurethral resection of the prostate (TURP), and open simple prostatectomy (OSP) in managing benign prostatic hyperplasia (BPH). A systematic literature search, encompassing studies up to August 2021, was conducted using specific search terms and abbreviations related to PAE and BPH. The seven studies involving 810 patients encompassed five randomized controlled trials (RCTs) and two observational studies comparing PAE with TURP and OSP. 

Despite the notable risk of bias concerns in the selected studies, the results indicated that TURP and OSP demonstrated more statistically significant improvements in urodynamic measures and BPH symptoms compared to PAE. Notably, PAE exhibited a significant improvement in erectile dysfunction compared to OSP and demonstrated positive trends in other outcome measures compared to TURP, although statistical significance was not reached. PAE also showed a favorable safety profile, with fewer adverse events and minor complications than TURP and OSP. 

However, uncertainties persist regarding the long-term effectiveness of PAE. In conclusion, PAE emerges as a promising treatment option for symptomatic BPH patients who are not suitable candidates for surgery or have experienced failed medical therapy. While PAE groups reported fewer adverse events, ongoing and longer-term studies are imperative to gain a deeper understanding of the comparative benefits of PAE in relation to other available treatment modalities.

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01397-1