3:57 PM, Abstract No. 299 - The preliminary outcome of prostatic arteries embolization with bead block for patients with benign prostatic hyperplasia

Abstract

To evaluate the preliminary clinical outcome of Prostatic Arteries Embolization (PAE) with Bead Block in patients with benign prostatic hyperplasia (BPH). One hundred fifty patients, with BPH and moderate to severe lower urinary tract symptoms (LUTS) refractory to medical therapy for at least 6 months, underwent PAE with spherical polyvinyl alcohol (PVA) particles - Bead Block 300µm - 500µm, between October 2012 and August 2014. The clinical success was evaluated by clinical improvement of International Prostate Symptoms Score (IPSS), Quality of Life (Qol) and International Index Erectile Function (IIEF) questionnaires and by changes from baseline of Prostate Volume (PV), Prostatic Specific Antigen (PSA), Peak Urinary Flow rate (Qmax) and post-void Residual Volume (PVR) at 1, 3 and every 6 months after PAE. There was not any technical failure. Three patients was lost to follow up, therefore 146 patients were controlled. Mean values: procedure time 80.3’; fluoroscopy time 20.5’; radiation 3842.1 dGycm; IPSS / Qol improvement of 10.4 ± 8.1 / 1.58 ± 1.01 points (32.5% / 20.7%). IIEF improvement 1.3 ± 3.0 (19.5%) points; PV reduction 26.2 ±31.5 (28.1%); Qmax improvement 4.7 ± 5.4 mL/s (35%); PSA reduction 3.2 ± 4.2 ng/ml (29.1%). There were 14 initial clinical failures (6.5%). There were 22 patients who were followed over 1 year. In this group of patients there were 2 (9.1%) initial clinical failures, thus the short term clinical success was 90,9%. In the same group of 22 controlled patients over 1 year there was 1 clinical failure at 1 year. Therefore, there was a clinical success over 1 year in 19/22 patients (86.4%). Overall in this group of 150 patients as minor complications there were 2 cases of hematuria, 2 cases of hematospermia, 1 case of slight rectorragia and 1 case of urinary infection. All these adverse events were self controlled. There were no major complications, no sexual dysfunction. PAE with Bead Block for patients with BPH is an efficient and safe procedure with very good preliminary outcome.