Benign prostatic hyperplasia (BPH) commonly causes moderate-to-severe lower urinary tract symptoms (LUTS) and may result in indwelling catheter (IDC) dependence. Prostate artery embolisation (PAE) is gaining traction as a minimally invasive alternative to medical and surgical therapies. This study evaluates the effectiveness of PAE in improving symptom scores, quality of life (QoL), and catheter independence in a Western Australian population.

We retrospectively reviewed 74 PAE procedures performed across two Perth hospitals between September 2019 and February 2025. Patients included those with significant LUTS (n=46) or IDC dependence (n=28). Pre- and post-procedure data—including IPSS, QoL, prostate volume, and catheter status—were gathered via institutional records, imaging, and structured phone interviews. Mean follow-up was 108 days.

A total of 74 procedures were performed with a mean patient age of 75. Mean prostate volume in the LUTS group was 150cc and 180cc in the IDC group. PAE led to a significant reduction in IPSS (20.1 to 5.7, p < 0.00001) and QoL scores (4.6 to 1.2, p < 0.00001). 61% of IDC dependent patients had successful removal of catheter post-operatively. Volume of embolic used was moderately correlated with improvement in QoL scores (r = +0.41, p = 0.046) in the LUTS sub-group. There were 3 complications (4%).

In this Australian cohort, prostate artery embolisation (PAE) was demonstrated to be a safe and highly effective treatment for benign prostatic hyperplasia with significant improvements in lower urinary tract symptoms and quality of life. The procedure was associated with low complication rates and showed a moderate correlation between embolic volume and QoL improvement in symptomatic patients. These findings support the incorporation of PAE into contemporary BPH management pathways; however, further research is warranted to better define the impact of procedural variables on clinical outcomes.