Comparison of Nonspherical Polyvinyl Alcohol Particles and Microspheres for Prostatic Arterial Embolization in Patients with Benign Prostatic Hyperplasia.

Jin Ho Hwang,Il Soo Chang,Hae Jeong Jeon,Sung Hyun Paick,Sang Woo Park,Hyoung Keun Park,Hyeong Gon Kim,Sung Il Jung,Yong Soo Lho

doi:10.1155/2017/8732351

Jin Ho Hwang, Il Soo Chang + Show 7 more

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https://doi.org/10.1155/2017/8732351

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Abstract

Purpose To report early results following prostatic artery embolization (PAE) and compare outcomes between nonspherical polyvinyl alcohol (PVA) particles and microspheres to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Methods PAE was performed in nine patients (mean age: 78.1 years) with symptomatic BPH. Embolization was performed using nonspherical PVA particles (250–355 μm) in four patients and microspheres (300–500 μm) in five patients. Results PAE was technically successful in all nine patients (100%). During a mean follow-up of 10.1 months, improvements in mean International Prostate Symptom Score (IPSS), Quality of Life (QoL), prostatic volume (total volume and transition zone), and peak urinary flow (Qmax) were 9.8 points, 2.3 points, 28.1 mL, 17.8 mL, and 4.5 mL/s, respectively. Clinical success was obtained in seven of nine patients (78%). Patients in the microsphere group showed greater improvement in IPSS, QoL, prostatic volume, and Qmax compared to patients in the nonspherical PVA particle group. However, significant difference was noted only in the prostatic volume. Conclusion PAE is a feasible, effective, and safe treatment option for BPH with LUTS. Use of microspheres showed greater prostatic volume reduction compared to nonspherical PVA particles.

Highlights

Benign prostatic hyperplasia (BPH) is prevalent in men over 50 years of age [1, 2] and frequently causes lower urinary tract symptoms (LUTS) consisting of an incomplete emptying sensation, hesitancy, decreased urinary stream, urinary frequency, urgency, and nocturia [3, 4].The gold-standard treatment for BPH is surgery via transurethral prostatic resection (TURP) [5]
From April 2011 to March 2014, a total of nine patients presented with LUTS related to BPH and underwent prostatic artery embolization (PAE)
PAE was technically successful in all nine patients (100%)

Summary

Introduction

Benign prostatic hyperplasia (BPH) is prevalent in men over 50 years of age [1, 2] and frequently causes lower urinary tract symptoms (LUTS) consisting of an incomplete emptying sensation, hesitancy, decreased urinary stream, urinary frequency, urgency, and nocturia [3, 4].The gold-standard treatment for BPH is surgery via transurethral prostatic resection (TURP) [5]. Benign prostatic hyperplasia (BPH) is prevalent in men over 50 years of age [1, 2] and frequently causes lower urinary tract symptoms (LUTS) consisting of an incomplete emptying sensation, hesitancy, decreased urinary stream, urinary frequency, urgency, and nocturia [3, 4]. Surgical treatment, even laser enucleation or photovaporization, is associated with complications such as irritating urinary symptoms, retrograde ejaculation, impotence, and hemorrhage [6, 7]. Even though long-term pharmacotherapy can be effective, it is associated with adverse effects such as dizziness, orthostatic hypotension, headache, erectile disorders, impotence, and decreased libido. Long periods of medication are hard to maintain due to poor compliance, high costs, and drug interactions [8]

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