The aim of this multicentric study was to evaluate the efficacy and security of Prostatic Artery Embolization (PAE) to remove indwelling urinary catheter (IUC) in benign prostatic hyperplasia. Secondary objectives were to identify associated factors correlated to clinical efficacy of PAE and assess the proportion of technical success in this specific population.

Consecutive patients who underwent PAE for IUC related to benign prostatic hyperplasia (BPH) were retrospectively included in this multi-institutional study. Patients were excluded when the follow-up was less than 18 months (except for early death). Clinical efficacy at long term was defined as the removal of the IUC without relapse or requirement of prostate surgery at the end of follow-up. For evaluation of associated factors of clinical efficacy, univariate and multivariate logistic regression was used. Catheter-free survival was assessed using Kaplan-Meier analysis. 

A total of 140 men (median age: 82.5 [73-88.2] years; range: 46-100 years) with IUC were included in six French University Hospital Centers from January 2017 to March 2019. Initial successful catheter removal following PAE occurred in 115/140 (82,1%) patients and intermediate TWOC delay average was 4 [2-6] months (range: 1-36 months) (range: 1- 12 weeks).  At the last available follow-up (median: 27 [24-34] months (range: 1−89 months), 87/140 (62,1%) patients were catheter-free and the intermediate relapse delay was 9.5 [4-16] months (range: 1-31 months Overall, 3/140 (2,1%) patients encountered major complications (penile ulceration for one patient and femoral approach’s hematoma which required endovascular intervention for one patient). None significantly association between the patients or technical variables and the long-term clinical success was found on univariate analysis. There was no Centre effect.

Long-term outcomes of this retrospective multicenter study are in favor of establishing PAE as an option for IUC removal in patients in AUR caused by BPH, with a long-term clinical efficacy rate of 62,1% and few major complications (2,1%). In this specific population, no predictive factors were identified for PAE clinical efficacy.