Transurethral prostatic sequester/fragment and avascular necrosis of the glans penis after prostatic artery embolization (PAE)

Minimally invasive treatments like prostatic artery embolization (PAE) are effective, low-morbidity alternatives for managing large-volume benign prostatic hyperplasia. This case report describes a patient with lower urinary tract symptoms and acute urinary retention treated with bilateral PAE. Though initially successful, complications included glans necrosis, urinary tract infection, prostatitis, and urosepsis, all of which resolved. Histological analysis revealed necrotic prostate tissue, and follow-up MRI showed a central prostate defect. No long-term issues were observed. The report underscores the need for awareness of rare complications, proper technique, and understanding vascular anatomy to ensure PAE safety and effectiveness.