Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis



To compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia.


We prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL).


All groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (Q max), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and Q max. TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher Q max and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria.


TURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.

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Fig. 1



Benign prostatic hyperplasia


Bladder contractility index


Bladder outlet obstruction


Bladder outlet obstruction index


Computed tomography

P det :

Detrusor muscle pressure


Digital rectal examination


Digital subtraction angiography


Erectile dysfunction


Inferior vesical artery


Infravesical obstruction


Institutional review board


International index of erectile function


International prostate symptom score


Lower urinary tract symptoms


Magnetic resonance imaging

Q max :

Maximum urinary flow rate


Original PAE method


Post-void residual urine volume


Prostate artery embolization


Prostate specific antigen


Proximal embolization first then embolize distal method of PAE


Quality of life


Transrectal ultrasound


Transurethral resection of the prostate


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The authors thank Vanessa Cristina de Paula Rodrigues, Sardis Honoria Harward, and Andre Moreira de Assis for their important collaboration.

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Correspondence to Francisco C. Carnevale.

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Carnevale, F.C., Iscaife, A., Yoshinaga, E.M. et al. Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis. Cardiovasc Intervent Radiol 39, 44–52 (2016).

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  • Embolization/embolisation/embolotherapy
  • Therapy
  • Prostate
  • Urinary tract