Society of Interventional Radiology (SIR) 2026 Practice Guidance Document for Prostatic Artery Embolization

Prostatic artery embolization (PAE) is a minimally invasive procedure for the management of benign prostatic hyperplasia (BPH), a common cause of lower urinary tract symptoms (LUTS) in older men. Since the Society of Interventional Radiology (SIR) 2019 Multisociety Consensus Position Statement on PAE, there has been rapid growth in clinical evidence, technological innovations, and increased acceptance of PAE as an alternative to transurethral resection of the prostate and other conventional surgical treatments. Notably, PAE has gained a place in multiple guidelines, including the American Urological Association's most recent guidelines, as a viable option for managing BPH-related LUTS. This practice guidance document synthesizes new clinical data and aims to provide updated guidance on patient selection, procedural technique, periprocedural care, outcome measures, safety, and future research directions. This document was developed by an SIR-appointed writing group of interventional radiologists and researchers with specialized expertise in PAE. The group analyzed published data up to 2025, referencing prior SIR guidelines and other relevant international standards. A wide array of literature, including randomized controlled trials, meta-analyses, retrospective studies, and expert opinions, was used to form this updated guidance.