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Lower urinary tract symptoms secondary to benign prostatic enlargement (LUTS BPE)

This is a condition caused by a non-cancerous increase in the size of the prostate. This can block the flow of urine, so the symptoms include feeling an increased need to urinate, often at night. When urinating, it can be difficult to empty the bladder completely. Visit NHS Choices prostate enlargement page for more information.

Prostate artery embolisation (PAE)

PAE is an operation which involves injecting small particles into the blood vessels that supply the prostate, causing the prostate to shrink over time. This treatment was assessed by NICE in 2013 and was given a ‘Research Only’ recommendation (NICE interventional procedures guidance), which means that it shows promise but more data is needed before it can be recommended for routine use in the NHS. For more information on the PAE procedure itself, please visit the Southampton University Hospital patient information page.

Other treatments

Other currently available treatment options include transurethral resection of the prostate (TURP), a surgical procedure to remove some of the prostate through the urethra. This is the most commonly performed treatment for LUTS. Another treatment option is open prostatectomy and  laser ablation/enucleation of the prostate.

Cedar's role

Cedar co-ordinated a register study on a new treatment for lower urinary tract symptoms secondary to benign prostatic enlargement called PAE. This register project was commissioned by the NICE Interventional Procedures programme in 2013. This enables us to collect data on patients treated using PAE and other surgical methods. In turn, this will help us answer the following questions:

  • Is PAE a safe and effective treatment option for LUTS BPE?
  • How does PAE compare with conventional surgical treatments?
  • Which patients would most benefit from PAE over the other treatment options?

We have successfully recruited 300 patients from 19 NHS trusts in the UK over a 12-month period. 210 of these are PAE patients, 77 were TURP patients and 13 HoLEP patients were also recruited.  Patients will undergo clinical examinations prior to the procedure and at 3 and 12 months after their procedure.


Ray, A. F., Powell, J., Speakman, M. J., Longford, N. T., DasGupta, R., Bryant, T., ... & Hacking, N. (2018). The UK ROPE Study: efficacy and safety of prostate artery embolisation for benign prostatic hyperplasia. An observational study and propensity matched comparison with transurethral resection of the prostate. BJU international, 122(2), 270-282.

Details of the UK ROPE Study:

  • Full title of study: ROPE registry project to determine the safety and efficacy of prostate artery embolisation (PAE) for lower urinary tract symptoms secondary to benign prostatic enlargement (LUTS BPE).
  • Chief Investigator: Dr Grace Carolan-Rees
  • Research Sites: 19 UK sites: 16 England, 1 Scotland, 1 Northern Ireland
  • Sponsor: Cardiff and Vale University Health Board
  • Sponsor reference: 14-DMD-5868
  • Research Ethics Committee reference: 14-NE-0128