JOURNAL OF UROLOGY AND ANDROLOGY RESEARCH
Perspective Article
Oct 06, 2026 19 39

Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis

Rustem Izbassarov 1 * ,
Yuriy Pak 2,
Kuandyk Beisenov 2,
Yerzhan Sharapatov 1,
Alen Uristembayev 2
1 Department of Urology and Andrology of the NJSC « Astana Medical University», Astana, Kazakhstan2 State Communal Enterprise on the Right of Economic Management "City Multidisciplinary Hospital №2" of the Akimat of Astana, Astana, Kazakhstan* Corresponding Author
Journal of Urology and Andrology Research, 1(1), 2026, juar004
Publication date: Oct 06, 2026
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ABSTRACT

Primary objective: To systematically evaluate and synthesize current clinical evidence on the impact of prostatic artery embolization (PAE) on erectile and ejaculatory function in men treated for benign prostatic hyperplasia (BPH).
Secondary objectives: To summarize, where reported, changes in prostate volume, PSA, IPSS/QoL, procedure-related adverse events, and cost-effectiveness data. These are presented separately from, and do not substitute for, the primary sexual-function analysis.
Materials and methods: A systematic review was conducted in accordance with the PRISMA 2020 statement. Four databases (PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus) were searched to June 2026. Eligible studies were RCTs and prospective cohort studies reporting IIEF-5 and/or MSHQ-EjD outcomes with a minimum 3-month follow-up. Risk of bias was assessed with RoB 2 (randomized trials), ROBINS-I (non-randomized comparative studies), and the Newcastle–Ottawa Scale (single-arm cohorts). Certainty of evidence was evaluated using the GRADE approach. The protocol was not prospectively registered in PROSPERO (acknowledged as a limitation). Given clinical and methodological heterogeneity across studies, a quantitative meta-analysis was not performed; a narrative synthesis is presented.
Results: PAE was associated with a markedly lower rate of retrograde ejaculation (0–5%) than TURP or laser enucleation (56–85%), and with a stable-to-modestly-improved IIEF-5 score (+1.5 to +2.5 points at 12 months), attributed largely to LUTS relief and discontinuation of alpha-blockers/5-ARIs rather than a direct vascular effect on erectile tissue.
Conclusion: Current evidence supports PAE as an organ-preserving option with a superior sexual-function profile relative to TURP/HoLEP for sexually active men with BPH who prioritize preservation of antegrade ejaculation, though the certainty of this evidence is limited by open-label trial designs, non-validated outcome measures in several studies, and the absence of prospective registration.

KEYWORDS

Benign Prostatic Hyperplasia Prostatic Artery Embolization Sexual Function Erectile Function Ejaculation IIEF-5 GRADE

CITATION (Vancouver)

Izbassarov R, Pak Y, Beisenov K, Sharapatov Y, Uristembayev A. Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis. Journal of Urology and Andrology Research. 2026;1(1):juar004.
APA
Izbassarov, R., Pak, Y., Beisenov, K., Sharapatov, Y., & Uristembayev, A. (2026). Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis. Journal of Urology and Andrology Research, 1(1), juar004.
Harvard
Izbassarov, R., Pak, Y., Beisenov, K., Sharapatov, Y., and Uristembayev, A. (2026). Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis. Journal of Urology and Andrology Research, 1(1), juar004.
AMA
Izbassarov R, Pak Y, Beisenov K, Sharapatov Y, Uristembayev A. Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis. Journal of Urology and Andrology Research. 2026;1(1), juar004.
Chicago
Izbassarov, Rustem, Yuriy Pak, Kuandyk Beisenov, Yerzhan Sharapatov, and Alen Uristembayev. "Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis". Journal of Urology and Andrology Research 2026 1 no. 1 (2026): juar004.
MLA
Izbassarov, Rustem et al. "Impact of Prostatic Artery Embolization on Sexual Function and Ejaculation in Men with Benign Prostatic Hyperplasia: A Review and Comparative Analysis". Journal of Urology and Andrology Research, vol. 1, no. 1, 2026, juar004.

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