Post-procedural prostatic artery pseudoaneurysm causing severe hematuria treated with transcatheter embolization

Prostatic artery pseudoaneurysm is an exceptionally rare vascular complication and an uncommon cause of gross hematuria, typically occurring after urologic instrumentation or surgical procedures such as transurethral resection of the prostate (TURP). We describe the case of a 73-year-old male with a history of TURP and recent lower urinary tract instrumentation who presented with recurrent gross hematuria and symptomatic anemia. Computed tomography angiography (CTA) of the abdomen and pelvis demonstrated a 1.1 × 0.6 cm pseudoaneurysm arising from the distal left prostatic artery adjacent to the prostatic apex. Given persistent bleeding despite conservative measures, the patient underwent image-guided transcatheter embolization using a microcatheter system and Gelfoam slurry, achieving complete resolution of hematuria without recurrence. This case demonstrates the diagnostic value of CTA in identifying rare vascular causes of hematuria and highlights targeted transcatheter embolization as an effective, minimally invasive definitive treatment for post-procedural prostatic artery pseudoaneurysm.