Prostatic Artery Embolization: A Viable Option for Catheter Independence after Failed Medical Management of Urinary Retention.

This report aimed to evaluate trial without catheter (TWOC) success after prostatic artery embolization (PAE) in catheterized men who had failed medical management and to identify predictors of success and retreatment patterns. Retrospective single-center exploratory analysis included 53 consecutive catheterized men undergoing PAE between January 2019 and March 2025. TWOC succeeded in 29 (54.7%) of 53 patients, lower than prior series, likely reflecting the chronic catheter-dependent cohort and lower bilateral embolization rate. Among successful cases, 2 (6.9%) of 29 experienced recurrent retention within 1 year. Bilateral embolization was associated with higher success (P = .024) and independently predicted TWOC success (odds ratio, 3.38; 95% CI, 1.01-13.37). Larger prostate volume showed a nonsignificant trend toward success (P = .066). Among 24 initial TWOC failures, 13 underwent surgical retreatment at a median of 9.0 months (interquartile range, 5.5-15.7 months); 11 of 13 achieved catheter independence. PAE may represent a pragmatic second-line option in chronically catheterized men when endoscopic surgery is unsuitable or their side effects are undesirable.