Clinical outcomes following prostatic artery embolization in a Taiwanese cohort: association between current smoking and symptomatic improvement.

PURPOSE: To evaluate clinical outcomes and safety following prostatic artery embolization (PAE) in a Taiwanese cohort and to identify factors associated with symptomatic improvement. MATERIALS AND METHODS: Between April 2018 and January 2025, 131 consecutive patients with symptomatic benign prostatic hyperplasiawho failed or were intolerant to medical therapy were treated with PAE. Clinical outcomes were assessed using International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume, and prostate-specific antigen (PSA) at baseline, 1 month, and 6 months. Multivariable logistic regression was performed to identify factors associated with limited symptomatic improvement. RESULTS: Among 110 patients completing 6-month follow-up, mean IPSS improved from 22.5 ± 5.7 at baseline to 8.6 ± 7.4 at 6 months (P < 0.001). Quality-of-life scores, prostate volume, and PSA levels also improved significantly. Clinical success was achieved in 93 of 110 patients (84.5%) using the predefined composite endpoint, whereas 80 of 110 patients (72.7%) achieved ≥50% IPSS reduction. Twenty-one of 131 patients (16.0%) did not complete 6-month follow-up. Current smoking was independently associated with limited symptomatic improvement (adjusted OR 3.66, 95% CI 1.13-11.85; P = 0.030). CONCLUSION: PAE was associated with significant improvements in symptoms, quality of life, prostate volume, and PSA levels, with an acceptable safety profile. Current smoking was associated with reduced symptomatic improvement following PAE. However, given the small number of smokers, wide confidence intervals, and the potential for residual confounding, this finding should be regarded as exploratory and warrants confirmation in larger multicenter studies.