Abstract
Purpose
To evaluate the hypothesis that infectious adverse events following prostatic artery embolization (PAE) are comparable to those following other treatment options for benign prostatic hyperplasia (BPH).Materials and methods
A literature review was conducted until August 2025 to identify studies reporting infectious outcomes, including urinary tract infection (UTI), prostatitis, and urosepsis, after PAE for BPH. Both comparative and non-comparative studies, including randomized controlled trials (RCTs), prospective, and retrospective observational designs, were included.Results
Thirty-nine studies met the eligibility criteria: 5 RCTs, 14 prospective, and 20 retrospective cohorts. Among comparative studies, the median reported UTI percentage was 3.7% (IQR 1.9%-5%), range 0%-27.5% across 1,722 patients, and 4.8% (IQR 2.7%-27.4%), range 1.6%-36.5% across 11,393 patients who underwent PAE and transurethral resection of the prostate (TURP), respectively. In prospective non-comparative cohorts, the median reported UTI percentage was 3.5% (IQR 1.7%-6.9%), range 1%-13.3% across the 1,172 included patients. Among retrospective non-comparative cohorts, the median reported UTI percentage was 3% (IQR 1.6%-4.3%), range 0.3%-11.8% across the 5,752 included patients. Six non-comparative studies reported infectious adverse events in patients with indwelling catheters. The median reported percentage of infectious adverse events was 5.5% (IQR 2.6%-11.5%), ranging from 1% to 12.7% among the 379 included patients. Specific data on prostatitis and urosepsis were infrequently reported as adverse events across the included studies.Conclusions
Infectious adverse events following PAE appear comparable to those observed after comparator procedures such as TURP. Higher infection percentages were observed in subgroups of patients with indwelling catheters.