Among surgical procedures for benign prostatic hyperplasia (BPH), prostatic artery embolization (PAE) is associated with worse complication rates compared with transurethral resection of prostate (TURP) and prostatic urethral lift (PUL), investigators reported at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana.
In an observational study of 12,902 men with BPH in New York State from 2014 to 2018, 335 men received PAE, 11,205 TURP, and 1362 PUL. PAE exhibited the highest 30-day (19.9%) and 90-day (35.6%) rates of hospital readmission or emergency department visits. The rates, respectively, were 13.9% and 20.1% for TURP and 10.6% and 16.4% for PUL, Brendan L. Raizenne, MD, of the University of Montreal, Canada, reported. Non-specific abdominal pain was the chief complaint for both 30-day (14.3%) and 90-day (26.8%) readmission after PAE.
After 2 years of follow-up, PAE had a significantly higher retreatment rate (28.5%) compared with TURP (3.4%) and PUL (8.5%). No one who underwent PAE developed stricture. The higher retreatment rate after PAE may reflect an older, sicker patient population or patients who cannot tolerate surgical procedures, co-investigator Bilal Chughtai, MD, of Weill Cornell Medicine/New York Presbyterian Hospital in New York, New York, explained in an interview. PAE may also be performed for other indications such as refractory hematuria.
“Further studies should focus on identifying what type of patient would benefit the most from PAE,” Dr Chughtai said. “There are a lot of novel minimally invasive surgical techniques. Reasons for reintervention vary. We need to figure out which patients are appropriate candidates for which procedures.”
Raizenne BL, Oumedjbeur K, Mao J, et al. Prostatic artery embolization compared to trans-urethral resection of the prostate and prostatic urethral lift: A real-world population-based study. Presented at: AUA 2022; May 13-16, 2022, New Orleans, Louisiana. Abstract MP01-05.