The purpose of this study was to determine the rate of ejaculatory dysfunction that develops following prostate artery embolization (PAE) and identify predictive factors.

Thirty-nine men (mean age, 67.9 ± 8.1 ([SD)] years; range: 52–84 years) who underwent PAE were retrospectively asked to complete the male sexual health questionnaire-ejaculation dysfunction (MSHQ-EjD) short form. Pre-treatment, procedural, and post-treatment variables were also collected.

A total of four patients (4/39, 10.3%) developed ejaculatory dysfunction following PAE, with one (1/4, 25%) reporting improvement in his ejaculatory dysfunction over time. When evaluating the group as a whole there was no significant difference between the pre and post-treatment answers of patients when asked about how often they ejaculate when having sexual activity (P = 0.77), strength of ejaculation (P = 0.86), or volume of ejaculation (P = 0.67). Similarly, the total MHSQ-EjD score was not different when evaluating the group as a whole pre (11.4 ± 5.3 [SD]; range: 1–15) and post-treatment (10.7 ± 5.3 [SD]; range: 1–15) (P = 0.54), nor was the degree of bother from ejaculatory difficulties significantly different (0.82 ± 1.1 [SD]; range: 0–5 vs. 1 ± 1.1 [SD]; range: 0–5; P = 0.9). When comparing those who did to those who did not develop ejaculatory dysfunction, univariable analysis demonstrated that post void residual volume was significantly greater in those who did develop dysfunction (median, 202 mL; IQR: 274; range: 40–588) than in those who did not (median, 58 mL; IQR: 124; range: 0–408) (P = 0.04).

We found that 10.3% of patients undergoing PAE develop ejaculatory dysfunction and those with greater post void residual volume may be at increased risk. However, the data should be interpreted with caution given the small sample size and more, preferably prospective, data are needed to determine the true rates of ejaculatory dysfunction following PAE.