25% of men require reintervention within 5 years of prostate artery embolization
A significant number of men who undergo prostatic artery embolization (PAE) as their first procedure for benign prostatic hyperplasia (BPH) may eventually require reintervention.
A new paper in the Journal of Vascular and Interventional Radiology describes reintervention rates of men with BPH in the years following PAE. According to the data, as many as 25% of these men will require additional treatment within five years of their first intervention. The new data provide valuable insight into outcomes that are not yet well described, authors of the paper contend.
“Published reintervention estimates after PAE have ranged from approximately 16%–51% at 40 years; this wide range reflects differing endpoint definitions (for example, whether medical treatment, repeat PAE, or specific surgical modalities are counted) as well as potential differences in durability, and derive predominantly from single-center series or international registries with limited generalizability to U.S. practice patterns,” writes Tarub S. Mabud MD, MSc, with the division of vascular and interventional radiology at Columbia University Irving Medical Center in New York. “The durability of PAE in routine U.S. practice, outside of high-volume academic centers and protocolized trials, remains less well characterized.”
For their study, researchers retrospectively analyzed the MarketScan Commercial and Medicare databases from 2017 through 2025, identifying 959 men age 50 or older who underwent PAE as their initial BPH procedure. The patients had a median age of 68 years, and 55% were enrolled in Medicare.
The cumulative incidence of any BPH-directed reintervention for the group was 7.5% at one year, 17.1% at three years and 25.8% at five years. The number of patients remaining at-risk decreased substantially over the five-year follow-up period, with only 23 considered at-risk at that point.
Transurethral resection of the prostate was the most common reintervention, accounting for 28 procedures, or 34.6% of all reinterventions. Laser enucleation was performed in 16% of cases, followed by repeat PAE in 14.8% and laser vaporization in 13.6%. The team did not identify any patient characteristics that were significantly associated with the risk of requiring another procedure.
The reintervention rate underscores the importance of discussing the potential need for additional treatment with patients considering PAE, researchers charge. They added that the findings also support continued efforts to optimize PAE techniques and improve long-term treatment durability.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.