3:36 PM Abstract No. 340 Perioperative blood loss after preoperative prostatic artery embolization in patients undergoing simple prostatectomy: a propensity score matched study

Abstract

To compare peri-operative blood loss in patients undergoing simple prostatectomy with and without preoperative prostatic artery embolization using propensity score matching. From September 2014 to July 2019, 56 patients (mean age, 67.4 ± 8.1 years) with prostatic hypertrophy resulting in severe lower urinary tract symptoms (LUTS). Twelve patients (66.8 ± 8.5 years) underwent preoperative embolization prior to prostatectomy. A retrospective chart review provided demographic data, medical history, pertinent labs (i.e., hemoglobin levels), procedural/operative information, surgical details (estimated blood loss (EBL), intraoperative transfusion), hospital course (length of stay, continuous bladder irrigation), and pathology. Ten patients (83%) underwent bilateral treatment. Two patients were treated unilaterally due to severe prostate artery stenosis. The mean EBL for patients without preoperative embolization was 548.9 ± 343.8 mL. The mean EBL for patients who underwent bilateral PAE was 250.0 ± 135.4 mL and unilateral PAE was 950 ± 70.7 mL. There was a significant difference in EBL between the no embolization and bilateral PAE group (P < 0.01). Twenty patients that underwent prostatectomy without preoperative embolization were selected for 2:1 Propensity Score Match Analysis based on age, race, surgery type, prostate gland size, and comorbidities. The mean EBL for these patients was 487.5, still statistically higher than the PAE group (P < 0.01). Propensity score match analysis also demonstrated a significant decrease in procedure time in patients who underwent preoperative PAE (P < 0.05). There were no differences in length of stay or perioperative transfusion requirements. For patients undergoing PAE, there were no complications related to the procedure. Preoperative PAE appears to be safe and may be effective in minimizing perioperative bleeding and procedure time. Unilateral treatment may not be sufficient in these cases.Tabled 12:1 MatchControlPAEPAge63.964.80.754RaceBlack10%20%0.516RaceHisp65%50%0.462RaceUnk25%30%0.787SurgType_Robot50%50%1.000PG.Size128.3112.30.137BPH15%10%0.703DM15%20%0.753HTN45%50%0.807HLD20%20%1.000CAD0%10%0.343Malignancy10%30%0.254 Open table in a new tab