Safety and efficacy of prostatic artery embolization in patients with hematuria due to benign prostate hyperplasia

Abstract Background Benign prostate hyperplasia (BPH) commonly affects aging men that can result in hematuria. For patients who are not suitable candidates for surgery, prostatic artery embolization (PAE) has emerged as a minimally invasive alternative. This study aimed to assess the safety and efficacy of PAE specifically for treating hematuria in BPH patients who cannot undergo surgery. Methods The study included n = 110 participants. PAE was performed, and outcomes of interest, including resolution of hematuria, improvement in lower urinary tract symptoms (LUTS), prostate volume (PV), and quality of life (QoL), were assessed. Adverse events were also analyzed. Results The study demonstrated a 100% clinical success rate in resolving hematuria at 3 months, with no recurrence observed during the 6-month follow-up. Mean hemoglobin levels increased, indicating successful resolution of bleeding. PAE also led to a significant reduction in LUTS severity, as measured by the International Prostate Symptom Score (IPSS). Improvement in the mean maximum urinary flow rate (Qmax) indicated enhanced urinary flow. Additionally, MRI measurements showed a reduction in prostate volume following PAE. These improvements contributed to enhanced QoL for the patients. Conclusions Prostatic artery embolization (PAE) was found to be a safe and effective treatment option for hematuria in BPH patients not suitable for surgery. PAE demonstrated a high success rate in resolving hematuria and resulted in significant improvements in LUTS, prostate volume, and QoL outcomes. These findings have important implications for clinical decision-making and improving patient care for BPH patients with hematuria. Further research and long-term follow-up studies are necessary to validate these findings and assess the durability of PAE outcomes in this patient population.