Interventional prostate procedure may reduce infection risk compared to standard of care
Rates of infectious adverse events following prostatic artery embolization (PAE) for benign prostatic hyperplasia appear comparable to or lower than those associated with other commonly used treatment options, including transurethral resection of the prostate, according to a new research.
Embolization is a minimally invasive treatment for an enlarged prostate, blocking blood flow and causing the gland to shrink, which improves urinary symptoms. Compared with surgical approaches such as resection, embolization can offer an alternative treatment for appropriately selected patients, especially men who are older in age.
Researchers recently conducted a thorough review of published studies evaluating infectious outcomes after embolization, including urinary tract infections, prostatitis and urosepsis. The analysis included 39 studies published through August 2025—five randomized controlled trials, 14 prospective studies and 20 retrospective cohorts.
The research team’s work was prompted by the growing use of prostate artery embolization in recent years, which is largely driven by increased life expectancy among this patient population.
“Despite the improvement of urinary symptoms, in terms of pathophysiology, tissue necrosis may increase the risk of microbial colonization and cause bacterial infections of the prostate and adjacent organs, such as the bladder or rectum, particularly in cases of non-target embolization,” Stelios-Elion Bousi, MD, with the Alfa Institute of Biomedical Sciences in Athens, Greece, and colleagues noted. “Furthermore, the presence of comorbidities such as diabetes mellitus and immunosuppression or factors such as indwelling urinary catheters could potentially lead to more severe infections or even urosepsis. Concerns about such infectious adverse events may influence clinicians decision-making regarding the use of PAE.”
Among comparative studies, the median reported UTI rate was 3.7% among 1,722 patients who underwent embolization, compared with 4.8% among 11,393 patients who underwent resection. The findings were similar in noncomparative studies. Prospective cohorts involving 1,172 embolization patients had a median reported UTI rate of 3.5%, while retrospective cohorts involving 5,752 patients had a median rate of 3%.
The research team also examined infectious complications among patients with indwelling urinary catheters, a population that may have a greater underlying infection risk. In this group, the median rate of infectious adverse events was 5.5%. The authors noted that the higher infection rates highlight the importance of considering catheter status when evaluating infection risk.
Specific reporting of prostatitis and urosepsis was limited across the available literature, making it difficult to draw firm conclusions about the incidence of those individual complications.
While the findings highlight the usefulness and safety of prostate artery embolization as a treatment option, the team acknowledged that additional work with more specific definitions of adverse events would be beneficial.
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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.