4:12 PM Abstract No. 70 Prostatic artery embolization for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a single-center experience with 2-year follow-up

Abstract

Prostate artery embolization (PAE) has emerged as an effective and favorable procedure for treatment lower urinary tract symptoms (LUTS) in patients with BPH. This study evaluates the efficacy of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). 256 patients who underwent PAE for either BPH with LUTS, hematuria, urinary retention or a combination of these from January 2014 to May 2019 were evaluated as part of an IRB-approved retrospective analysis at a single institution. Patients with active urinary tract infection (UTI), renal failure, urinary retention severe atherosclerosis were excluded from the analysis. Mean patient age was 68.2 years, mean prostate volume was 118.4 g, mean pre procedure IPSS, QOL, SHIM were 23.6, 4.7, and 15.4, respectively. Patients were evaluated at 1, 3, 6, 12, 24-month intervals following PAE. Adverse events were recorded using the Clavien-Dindo classification. Three months after PAE, mean IPSS decreased from 23.6 to 8.3 (↓65%, n = 213, P <0.001) and mean QOL improved from 4.7 to 1.5 (↓68%, n = 217, P <0.001). Twelve months after PAE, mean IPSS was 7.8 (↓6%, n = 122, P <0.001), mean QOL was 1.4 (↓ 7%, n = 121, P <0.001) and prostate size decreased from 116 g to 76 g (↓34%, n = 61, P <0.001). At 24 months, mean IPSS and QOL were 11.1 and 2.1 (↑42%, ↑50%, from 6 months, n = 11, P <0.001). Three patients required a second PAE procedure. 41% of patients had a grade I event, 7% had a grade II event and 0.1% had a grade IV event. PAE has been established as a clinically efficacious procedure for patients with BPH. Patients have reported promising long-term outcomes, including maintained relief of LUTS and significant improvement in quality of life.