Prostatic Urethral Angle Predicts PAE Response Only in Smaller Prostates

Pre-PAE MRI prostatic urethral angle (PUA) did not predict IPSS outcomes across 80 patients overall (all p>0.05), but in the subgroup with prostate volume <100 mL (n=28), larger PUA linked to better symptom response (62.4° vs 55.1° in responders, p=0.007). Retrospective; subgrou…

• Retrospective single-cohort study; 80 patients underwent pre-PAE MRI with PUA measured by two readers plus adjudication; baseline and post-PAE IPSS compared.
• In the <100 mL prostate subgroup, larger PUA independently predicted lower post-PAE IPSS on multivariable analysis (p=0.035), and a PUA × prostate volume interaction confirmed effect modification by prostate size in the full cohort (p=0.005).
• Key limitation: small overall n (80), retrospective design, and the key findings derive from a post-hoc subgroup (n=28), limiting generalizability and clinical applicability without prospective validation.

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