Prostatic Artery Embolization to Achieve Freedom from Catheterization in Patients with Acute Urinary Retention Caused by Benign Prostatic Hyperplasia

Purpose To determine the ability of prostatic artery embolization (PAE) to achieve freedom from catheterization in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH). Materials and methods This retrospective single-center study was performed between June 2014 and March 2019 in patients with lower urinary tract symptoms (LUTS) related to BPH. PAE was performed in 154 eligible patients, where 76 suffered from spontaneous AUR and had indwelling catheters placed and kept until the procedure because of the failure in the removal of the previous intermittent catheter. Each patient was followed for at least 12 months. The first trial without catheter was performed 3 days after PAE. The successful catheter removal within the first 30 days after PAE was considered as a clinical success. The rate of patients free from catheterization, LUTS relief, prostate volume (PV) and adverse events was recorded. Results Clinical success was achieved in 70 (92.1%) patients. The rates of patients free from catheterization were 90.3% (65/72), 83.3% (60/72) and 80.6% (58/72) at 3-, 6-, and 12-month follow-up, respectively. The median period of time from PAE to catheter removal was 10 days. However, 18 patients needed further interventions. The symptom scores revealed a continuous improvement in urinary symptoms. A statistically significant decrease in mean PV was observed at 3 and 12 months compared to its baseline value. No severe adverse events occurred. Conclusion PAE can achieve freedom from catheterization in patients with AUR caused by BPH.