Abstract No. 59 Prostate artery embolization in prostate size larger than 80 g: a single-center experience with 5-year follow up

Abstract

To evaluate the safety and efficacy of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) for prostates > 80 g. 381 patients underwent PAE for BPH with prostate size > 80 g from April 2014 to June 2020 were evaluated as part of an IRB-approved retrospective analysis at a single institution. 206 patients met inclusion criteria. Mean patient age was 70.7 ± 9.7 years, mean prostate volume was 143.1 ± 66.0 g, median (IQR) pre-procedure IPSS, QOL and PVR were 23.0 (IQR 10.0), 5.0 (IQR 2.0) and 156.0 (IQR 230.3) mL. Clinical and urodynamic outcomes were reviewed at 3, 6, and 12 months following PAE. Adverse events were recorded using the Clavien-Dindo classification. At 3 months median IPSS was 6.0 (IQR 7.0) (n = 178, P< 0.0001), median QOL was 1.0 (IQR 2.0) (n = 191, P< 0.0001), median PVR was 50.0 mL (IQR 82.7) (n = 44, P< 0.0001), mean prostate size was 94.5 g (n = 206, P< 0.0001). Six months after PAE, median IPSS was 5.0 (IQR 8.0) (n = 133, P< 0.0001), median QOL was 1.0 (IQR 2.0) (n = 136, P< 0.0001), median PVR was 43.0 mL (IQR 143.0) (n = 30, P = 0.001). At 12 months median IPSS was 5.0 (IQR 8.0) (n = 109, P< 0.0001), median QOL was 1 (IQR 2) (n = 110, P< 0.0001), median PVR was 103.5 mL (IQR 149.5) (n = 20, P = 0.002), and mean prostate size was 98.2 g (↓35%, n = 71, P< 0.0001). At 24 months, median IPSS was 8.0 (IQR 11.2) (n = 24, P< 0.0001), median QOL was 1.0 (IQR 3.0) (n = 23, P< 0.0001), and median prostate size was 109.3 g (↓29%, n = 20, P< 0.0001). At 36 to 60 months median IPSS was 6.0 (IQR 10.5) (n = 23, P< 0.0001), median QOL was 1 (IQR 2) (n = 24, P< 0.0001), and mean prostate size was 136.2 g (↓30%, n = 5, P = 0.09). 4 grade II or above complications occurred, urosepsis (n = 3) and stroke (n = 1), all other complications were self-limited grade I. PAE achieved a clinically and statistically significant improvement in lower urinary tract symptoms and secondary outcome measures in patients with prostates > 80g. PAE is an effective treatment for BPH with long-term sustained benefits.