AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025130065
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ORIGINAL RESEARCH ARTICLE

Efficacy of embolic microspheres of different sizes for the treatment of benign prostatic hyperplasia: Correlation with serum prostate-specific antigen levels

Chenyang Zhang1† ,  Weixing Mo2† ,  Jianxia Xu3 ,  Xiaozhong Zheng3 ,  Qinpan Rao3 ,  Tianyu Ke3 ,  Xiaoshan Huang3 ,  Junyi Xiang3* ,  Yin Gong4*
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1 School of the Second Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
2 Department of Radiology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, China
3 Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
4 Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
†These authors contributed equally to this work.
EJMO, 025130065 https://doi.org/10.36922/EJMO025130065
Received: 24 March 2025 | Revised: 11 June 2025 | Accepted: 16 June 2025 | Published online: 4 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Benign prostatic hyperplasia (BPH) is a common condition in aging men that can significantly impact quality of life. Prostatic artery embolization (PAE) has emerged as a minimally invasive treatment option. Objective: This study aimed to evaluate the clinical efficacy of super-selective PAE using microspheres of different sizes on BPH patients and investigate its correlation with serum prostate-specific antigen (PSA) expression. Methods: A prospective, single-blind randomized study was performed on 80 eligible patients treated between January 2020 and October 2022. Patients were randomly assigned to Group A (100 – 300 μm microspheres) or Group B (300 – 500 μm microspheres), with 40 patients each. Follow-ups were conducted at 1, 3, and 6 months post-embolization using ultrasound and/or computed tomography/magnetic resonance imaging, alongside PSA testing. Data collection covered prostate volume (PV), maximum urinary flow rate (Qmax), post-void residual (PVR), international prostate symptom score (IPSS), quality of life (QoL), clinical symptoms, obstruction relief, and PSA levels. Results: Significant improvements were observed in all parameters (IPSS, QoL, PV, PVR, and Qmax) at each follow-up point (all p<0.05). Group A showed superior outcomes at 6 months in both subjective (IPSS, QoL) and objective (PV, PVR, Qmax, PSA) parameters (all p<0.05). The PSA–PV correlation demonstrated a dose-response relationship. Minor complications occurred in Group A (20.0%) and Group B (12.5%), with no severe adverse events. Conclusion: PAE using 100 – 300 μm microspheres demonstrated superior outcomes and PSA reductions compared to larger particles, supporting its safety and efficacy as a treatment option for BPH.

Keywords
Benign prostatic hyperplasia
Embolic agents
Polyvinyl alcohol microspheres
Prostate artery embolization
Prostate-specific antigen
Funding
This research was supported by Zhejiang Provincial Medical and Health Science and Technology Plan under the project titled “Observation on the clinical efficacy of embolic microspheres of different particle sizes in the treatment of BPH and its correlation with serum PSA expression” with grant number (2020KY674).
Conflict of interest
The authors declare that there are no competing interests.
References
  1. Roehrborn CG, Egan KB, Miner MM, Ni X, Wong DG, Rosen RC. Erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) combined responders to tadalafil after 12 weeks of treatment. BJU Int. 2016;118(1):153-160. doi: 10.1111/bju.13406

 

  1. Cornu JN, Zantek P, Burtt G, et al. Minimally invasive treatments for benign prostatic obstruction: A systematic review and network meta-analysis. Eur Urol. 2023;83(6):534-547. doi: 10.1016/j.eururo.2023.02.028

 

  1. Carnevale FC, Antunes AA, Da Motta Leal Filho JM, et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: Preliminary results in two patients. Cardiovasc Intervent Radiol. 2010;33(2):355-361. doi: 10.1007/s00270-009-9727-z

 

  1. Sciacqua LV, Vanzulli A, Di Meo R, et al. Minimally invasive treatment in benign prostatic hyperplasia (BPH). Technol Cancer Res Treat. 2023;22:15330338231155000. doi: 10.1177/15330338231155000

 

  1. Pisco JM, Rio Tinto H, Campos Pinheiro L, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: Results of short- and mid-term follow-up. Eur Radiol. 2013;23(9):2561-2572. doi: 10.1007/s00330-012-2714-9

 

  1. Sun F, Sánchez FM, Crisóstomo V, et al. Benign prostatic hyperplasia: Transcatheter arterial embolization as potential treatment--preliminary study in pigs. Radiology. 2008;246(3):783-789. doi: 10.1148/radiol.2463070647

 

  1. Fang ZT, Yan ZP, Tang Y, et al. Transarterial prostatic embolization: Initial experience in hormone-induced benign prostatic hyperplasia in dogs. Chin J Radiol. 2013;47:551- 554. doi: 10.3760/cma.j.issn.1005-1201.2013.06.016

 

  1. Jeon GS, Won JH, Lee BM, et al. The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: A pilot study. J Vasc Interv Radiol. 2009;20(3):384-390. doi: 10.1016/j.jvir.2008.11.014

 

  1. Delgal A, Cercueil JP, Koutlidis N, et al. Outcome of transcatheter arterial embolization for bladder and prostate hemorrhage. J Urol. 2010;183(5):1947-1953. doi: 10.1016/j.juro.2010.01.003

 

  1. Bilhim T, Pisco J, Campos Pinheiro L, et al. Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol. 2013;24(11):1595-1602.e1. doi: 10.1016/j.jvir.2013.06.003

 

  1. Abt D, Müllhaupt G, Hechelhammer L, et al. Prostatic artery embolisation versus transurethral resection of the prostate for benign prostatic hyperplasia: 2-yr outcomes of a randomised, open-label, single-centre trial. Eur Urol. 2021;80(1):34-42. doi: 10.1016/j.eururo.2021.02.008

 

  1. Liu J, Guo J. Clinical application and clinical evaluation concerns of embolization microspheres. Chin J Med Instrum. 2024;48(6):694-698. doi: 10.12455/j.issn.1671-7104.240205

 

  1. Yuan K, Wang M, Duan F, et al. Preliminary application of super-selective prostatic artery embolization for the treatment of benign prostatic hyperplasia. J Chin Med Imaging. 2014;22:375-379.

 

  1. Torres D, Costa NV, Pisco J, Pinheiro LC, Oliveira AG, Bilhim T. Prostatic artery embolization for benign prostatic hyperplasia: Prospective randomized trial of 100-300 μm versus 300-500 μm versus 100- to 300-μm + 300- to 500-μm embospheres. J Vasc Interv Radiol. 2019;30(5):638-644. doi: 10.1016/j.jvir.2019.02.014

 

  1. Canat HL, Gurbuz C, Bozkurt M. Transurethral resection of the prostate (TURP) versus transperineal laser ablation (TPLA) due to benign prostatic hyperplasia (BPH): Prospective and comparative study. Int Urol Nephrol. 2023;55(11):2747-2752. doi: 10.1007/s11255-023-03717-8

 

  1. Gu L, Li Y, Li X, Liu W. Does previous transurethral resection of the prostate negatively influence subsequent robotic-assisted radical prostatectomy in men diagnosed with prostate cancer? A systematic review and meta-analysis. J Robot Surg. 2023;17(4):1299-1307. doi: 10.1007/s11701-023-01588-w

 

  1. Al-Bakri A, Al-Jaser A, Al-Gamdi K, et al. Safety of transurethral resection of large prostate. Urol Ann. 2023;15(2):162-165. doi: 10.4103/ua.ua_192_21

 

  1. Bruce A, Krishan A, Sadiq S, Ehsanullah SA, Khashaba S. Safety and efficacy of bipolar transurethral resection of the prostate vs monopolar transurethral resection of prostate in the treatment of moderate-large volume prostatic hyperplasia: A systematic review and meta-analysis. J Endourol. 2021;35(5):663-673. doi: 10.1089/end.2020.0840

 

  1. Iqbal J, Mashkoor Y, Nadeem A, et al. Shifting trends in prostate treatment: A systematic review comparing transurethral resection of the prostate and holmium laser enucleation of the prostate. Cureus. 2023;15(9):e46173. doi: 10.7759/cureus.46173

 

  1. Frandon J, Ghelfi J, Droupy S, Beregi JP. Prostatic artery occlusion: A new strategy to improve clinical outcomes of prostatic artery embolization? Transl Androl Urol. 2023;12(2):152-154. doi: 10.21037/tau-22-878

 

  1. Jankauskas T, Buržinskis E, Kaupas RS, Basevičius A, Jievaltas M. Prostatic artery embolization as a treatment option for symptomatic benign prostatic hyperplasia: Results from the prospective follow-up study in lithuania. Medicina (Kaunas). 2023;59(10):1871.doi: 10.3390/medicina59101871

 

  1. Marzano L, Thiounn N, Pereira H, et al. Prostatic artery embolization allows to maintain full sexual activity in patients suffering from bothersome lower urinary tracts symptoms related to benign prostatic hyperplasia. Cardiovasc Intervent Radiol. 2020;43(8):1202-1207. doi: 10.1007/s00270-020-02520-7

 

  1. Pilan BF, De Assis AM, Moreira AM, Rodrigues VCP, Rocha ADD, Carnevale FC. Prostatic artery embolization using polyethylene glycol microspheres: A 1-year follow-up prospective study including 30 patients. J Vasc Interv Radiol. 2023;34(12):2197-2202. doi: 10.1016/j.jvir.2023.08.037

 

  1. Bilhim T, McWilliams JP, Bagla S. Updated american urological association guidelines for the management of benign prostatic hyperplasia: Prostatic artery embolization made it into the guidelines! Cardiovasc Intervent Radiol. 2024;47(1):150-153. doi: 10.1007/s00270-023-03617-5

 

  1. Bilhim T. Prostatic artery embolization: An update. Korean J Radiol. 2023;24(4):313-323. doi: 10.3348/kjr.2022.0814

 

  1. Bilhim T. Long-term PAE results: What do we know. Semin Intervent Radiol. 2022;39(6):577-580. doi: 10.1055/s-0042-1759732

 

  1. Xu ZW, Zhou CG, Tian W, Shi HB, Liu S. Long-term efficacy and recurrence prediction of prostatic artery embolization for lower urinary tract symptoms secondary to Benign prostatic hyperplasia. Cardiovasc Intervent Radiol. 2022;45(12):1801-1809. doi: 10.1007/s00270-022-03272-2

 

  1. McNamara K, Picel AC. Commentary on “long-term efficacy and recurrence prediction of prostatic artery embolization for lower urinary tract symptoms secondary to Benign prostatic hyperplasia” Xu X, et al. CVIR 2022. Cardiovasc Intervent Radiol. 2022;45(12):1810-1811. doi: 10.1007/s00270-022-03312-x

 

  1. Schols RM, Connell NJ, Stassen LP. Near-infrared fluorescence imaging for real-time intraoperative anatomical guidance in minimally invasive surgery: A systematic review of the literature. World J Surg. 2015;39(5):1069-1079. doi: 10.1007/s00268-014-2911-6

 

  1. Sachdev AH, Gress FG. Celiac plexus block and neurolysis: A review. Gastrointest Endosc Clin N Am. 2018;28(4): 579-586. doi: 10.1016/j.giec.2018.06.004
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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