[Prostate artery embolization-2026 update : Technique, evidence, and role in the treatment of benign prostatic hyperplasia].

CLINICAL/METHODICAL ISSUE: Benign prostatic syndrome is the most common urologic condition in older men and substantially affects quality of life.

STANDARD RADIOLOGICAL

METHODS

Early stage disease is managed with pharmacotherapy. In advanced disease, transurethral resection is the surgical standard.

METHODICAL INNOVATIONS: For more than 10 years, prostatic artery embolization has provided a minimally invasive alternative performed under local anesthesia.

PERFORMANCE: Randomized trials and meta-analyses document a marked improvement in symptom score and quality of life with lower periprocedural morbidity than transurethral resection. Five-year data confirm durable symptom improvement, albeit with a higher reintervention rate than the surgical reference standard. Compared with combined medical therapy, embolization proved superior in a randomized trial. Unlike transurethral resection, there is no upper prostate volume limit.

ACHIEVEMENTS: With its inclusion in national and international guidelines, prostatic artery embolization has left the experimental stage.

PRACTICAL RECOMMENDATIONS: Detailed knowledge of the pelvic vascular anatomy and a clear imaging and navigation strategy are prerequisites. Avoidance of nontarget embolization is the central safety element. Novel embolic agents and potential expansion of indications are undergoing clinical evaluation.