Long-Term Outcome of Prostatic Artery Embolization for Patients with Benign Prostatic Hyperplasia: Single-Centre Retrospective Study in 1072 Patients Over a 10-Year Period

Purpose Assess long-term outcomes of prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH). Materials and Methods Single centre retrospective study from 2009–2019 including 1072 patients who received PAE and had available follow-up. Patients were evaluated yearly at 1–10 years post PAE using the International Prostate Symptom Score (IPSS) and quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax) and postvoid residual (PVR) volume. The need for prostatic medication, re-intervention rates, repeat PAE and prostatectomy rates were assessed with Kaplan–Meier survival analysis and compared between different embolic agents using Cox regression analysis. Results Mean follow-up time was 4.39 ± 2.37 years. At last follow-up visit, mean IPSS and QoL improvements were − 10.14 ± 8.34 ( p < .0001) and − 1.87 ± 1.48 ( p < .0001) points, mean PV reduction was − 6.82 ± 41.11 cm 3 ( p = 0.7779), mean PSA reduction was − 1.12 ± 4.60 ng/mL ( p = 0.9713), mean Qmax increase was 2.72 ± 6.38 mL/s ( p = 0.0005), mean PVR reduction was − 8.35 ± 135.75 mL ( p = 0.6786). There were 335 patients (31.3%) needing prostatic medication after PAE. Re-intervention rates were 3.4% at 1 year, 21.1% at 5 years and 58.1% at 10 years. Repeat-PAE rates were 2.3% at 1 year, 9.5% at 5 years and 23.1% at 10 years. Prostatectomy rates were 1.1% at 1 year, 11.6% at 5 years and 35.0% at 10 years. No significant differences were found between polyvinyl alcohol particles, Bead Block, Embospheres and Embozenes. Conclusion PAE induces durable long-term LUTS relief, with re-intervention rates of 20% in the first 5 years and 30%–60% > 5 years post-PAE.