Long-Term Outcome of Prostatic Artery Embolization for Patients with Benign Prostatic Hyperplasia: Single-Centre Retrospective Study in 1072 Patients Over a 10-Year Period.

Abstract

Assess long-term outcomes of prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH). Single centre retrospective study from 2009-2019 including 1072 patients who received PAE and had available follow-up. Patients were evaluated yearly at 1-10years post PAE using the International Prostate Symptom Score (IPSS) and quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax) and postvoid residual (PVR) volume. The need for prostatic medication, re-intervention rates, repeat PAE and prostatectomy rates were assessed with Kaplan-Meier survival analysis and compared between different embolic agents using Cox regression analysis. Mean follow-up time was 4.39 ± 2.37years. At last follow-up visit, mean IPSS and QoL improvements were -10.14 ± 8.34 (p < .0001) and -1.87 ± 1.48 (p < .0001) points, mean PV reduction was -6.82 ± 41.11 cm3 (p = 0.7779), mean PSA reduction was -1.12 ± 4.60ng/mL (p = 0.9713), mean Qmax increase was 2.72 ± 6.38mL/s (p = 0.0005), mean PVR reduction was -8.35 ± 135.75mL (p = 0.6786). There were 335 patients (31.3%) needing prostatic medication after PAE. Re-intervention rates were 3.4%at 1year, 21.1%at 5years and 58.1%at 10years. Repeat-PAE rates were 2.3%at 1year, 9.5%at 5years and 23.1%at 10years. Prostatectomy rates were 1.1%at 1year, 11.6%at 5years and 35.0%at 10years. No significant differences were found between polyvinyl alcohol particles, Bead Block, Embospheres and Embozenes. PAE induces durable long-term LUTS relief, with re-intervention rates of 20% in the first 5years and 30%-60% > 5years post-PAE.