To evaluate the outcomes of selective prostatic artery embolization (PAE) for benign prostatic hyperplasia (BPH). This study analyzes the safety and effectiveness of this method based on seven years of experience with this treatment modality at the Republican Clinical Hospital named after G.G. Kuvatov in Ufa from 2018to 2024

A systematic review and analysis were conducted involving 110 patients (mean age 76.8 ± 5.8 years) who underwent prostatic artery embolization between 2018 and 2024. In 95.3% of cases, a transradial approach was used. Various catheters with diameters ranging from 2.4 to 4.0 Fr were employed for embolization. The embolic material consisted of saturated microspheres with diameters ranging from 210.0 to 690.0 μm. To assess the efficacy of the procedure, we utilized the International Prostate Symptom Score (IPSS), transrectal ultrasound (TRUS) measurements for prostate volume assessment, prostate-specific antigen (PSA) levels, and urodynamic data. Clinical success was defined as the removal of urinary catheters or cystostomies and the ability to urinate independently.

The clinical success rate was 95.5% (2018-2024). Analyzing the efficacy metrics before and after the procedure revealed satisfactory functional improvements at 1, 3, and 12 months post-embolization.
Changes in IPSS: prior to the procedure: 30.2 ± 4.5 points; at 12 months: 6.1 ± 4.3 points.
TRUS measurements: before embolization: 123.5 ± 40.2 cm³; at 12 months: 45.0 ± 10.6 cm³.
PSA levels: before the procedure: 3.3 ± 2.5 ng/ml; at 12 months: 3.0 ± 1.4 ng/ml.
Uroflowmetry data: before embolization: 7.5 ± 1.8 ml/s; at 12 months: 12.9 ± 2.3 ml/s.

The clinical success rate was 95.5% (2018-2024). Analyzing the efficacy metrics before and after the procedure revealed satisfactory functional improvements at 1, 3, and 12 months post-embolization.
Changes in IPSS: prior to the procedure: 30.2 ± 4.5 points; at 12 months: 6.1 ± 4.3 points.
TRUS measurements: before embolization: 123.5 ± 40.2 cm³; at 12 months: 45.0 ± 10.6 cm³.
PSA levels: before the procedure: 3.3 ± 2.5 ng/ml; at 12 months: 3.0 ± 1.4 ng/ml.
Uroflowmetry data: before embolization: 7.5 ± 1.8 ml/s; at 12 months: 12.9 ± 2.3 ml/s.
No significant complications were observed following embolization. Mild complications occurred in the following instances: urinary tract burning in 31 patients (28.6%), transient hematuria in 5 patients (4.8%), mild pubic pain in 52 patients (47.6%), and subfebrile fever in 37 patients (33.3%). All complications resolved spontaneously within one week post-procedure without specific treatment.
Bilateral embolization was successfully performed in 100 patients (90.5%), while unilateral embolization was performed in 10 patients (9.5%) due to significant atherosclerosis and tortuosity of the iliac segment and pelvic arterial basin complicating catheterization of the prostatic arteries.
Urinary catheters and cystostomies were successfully removed in 105 patients (95.5%): on the first week post-procedure in 42 patients, on the second week in 52 patients, and on the third week in 11 patients.

The clinical success rate was found to be 95.5% based on our predefined metrics, indicating that prostatic artery embolization is a promising, safe, and alternative treatment method for BPH. It is likely one of the most suitable options for minimally invasive surgical treatment in patients who have contraindications for open surgery and comorbid conditions.