Patient description: The patient is a 63-year-old man presenting to the Emergency Department with a history of acute urinary retention in the past 2 days. Abdominopelvic CT scan revealed a large prostate and a bladder filled with urine. He is a candidate for urethral catheterization and TURP. Further evaluation revealed: Post-void residual: 71 mL Prostate volume (TRUS): 63 mL Prostate-specific antigen (PSA) level: 3.5 ng/mL His recent blood chemistry (3 days ago) was normal: Hgb: 13.6 g/dl WBC: 133000 /mm3 Plt: 370000 /ml PT: 12 second PTT: 34 second INR: 0.9 Creatinine: 0.5 mg/dl BUN: 10 mg/dl U/A: Color: yellow Appearance: cloudy PH: 5.3 Specific gravity: 1.010 Glc: 100 Nitrite: negative Ketone: none Leukocyte esterase: negative RBC: negative WBC: 2 WBCs/hpf U/C: negative

Clinical trial eligibility criteria: eligible ages (years): 40.0-999.0,  Lower Urinary Tract Symptoms Benign Prostatic Hyperplasia Urinary Frequency/Urgency Urinary Incontinence, Urge Incontinence, Urinary Nocturia Male aged ≥40 yr Willing, able and mentally competent to provide written informed consent and willing to comply with all study procedures and be available for the duration of the study Diagnosis of urinary symptoms (LUTS) from prostatic enlargement (BPH) refractory to medical therapy for at least 6 months. International Prostate Symptom Score >12  PUL 1. Active urinary tract infections, prostatitis, or interstitial cystitis. 2. Biopsy proven prostate, bladder, or urethral cancer. The following patients must undergo prostate biopsy with a minimum of 12 cores and have a negative histopathology report to be enrolled in the study Patients with digital rectal examination (DRE) findings suspicious for prostate cancer Patients with baseline PSA levels > 10 ng/mL Patients with baseline PSA levels >2.5 ng/mL and < 10ng/mL AND free PSA < 25% of total PSA Patients with cystoscopy findings suspicious for bladder cancer must undergo biopsy and have a negative histopathology report to be enrolled in the study 3. Significant median lobe enlargement. 4. Large prostates, volume >80 g. 5. Bladder atonia, neurogenic bladder disorder or other neurological disorder that is impacting bladder function (e.g. multiple sclerosis, Parkinson's disease, spinal cord injuries, etc.) 6. Urethral stricture, bladder neck contracture, sphincter abnormalities, bladder diverticulum, urinary obstruction due to causes other than BPH, or other potentially confounding bladder or urethral disease or condition 7. Urethral conditions that may prevent insertion of a rigid 20F cystoscope 8. Current urinary retention. 9. Acontractile detrusor. 10. Current gross hematuria 11. Known upper tract renal disease 12. Cystolithiasis 13. ASA > 3 or severe medical debilitating condition 14. History of pelvic irradiation or radical pelvic surgery 15. Known allergy to nickel. PAE 16. Active urinary tract infections, prostatitis, or interstitial cystitis. 17. Biopsy proven prostate, bladder, or urethral cancer. The following patients must undergo prostate biopsy with a minimum of 12 cores and have a negative histopathology report to be enrolled in the study Patients with digital rectal examination (DRE) findings suspicious for prostate cancer Patients with baseline PSA levels > 10 ng/mL Patients with baseline PSA levels >2.5 ng/mL and < 10ng/mL AND free PSA < 25% of total PSA Patients with cystoscopy findings suspicious for bladder cancer must undergo biopsy and have a negative histopathology report to be enrolled in the study 18. Unable to have CT angio of the prostate imaging 19. Bladder atonia, neurogenic bladder disorder or other neurological disorder that is impacting bladder function (e.g. multiple sclerosis, Parkinson's disease, spinal cord injuries, etc.) 20. Urethral stricture, bladder neck contracture, sphincter abnormalities, bladder diverticulum, urinary obstruction due to causes other than BPH, or other potentially confounding bladder or urethral disease or condition 21. Acontractile detrusor. 22. Known upper tract renal disease 23. Cystolithiasis 24. Any known condition that limits catheter-based intervention or is a contraindication to embolization, such as intolerance to a vessel occlusion procedure or severe atherosclerosis. Known major iliac arterial occlusive disease 25. ASA > 3 or severe medical debilitating condition 26. Baseline serum creatinine level > 1.8 mg/dl 27. Previous rectal surgery other than hemorrhoidectomy, or history of rectal disease 28. History of pelvic irradiation or radical pelvic surgery 29. Allergy to iodinated contrast agents