Abstract
BackgroundBenign prostate hyperplasia (BPH) remains a common cause of lower urinary tract symptoms (LUTS) in ageing men in South Africa and can impact significantly on the quality of life (QOL) of these patients. The Urology Department at Steve Biko Academic Hospital (SBAH) can generally only offer men with LUTS the following treatment options: watchful waiting, medical treatment and surgical management. In men with symptomatic BPH, who are refractory to medical treatment, where anaesthesia is contra-indicated because of co-morbidities or transurethral resection of the prostate (TURP) is contra-indicated because of the prostate size, the Urology and Radiology departments at SBAH recently introduced prostate artery embolisation (PAE).AimTo assess the outcome of PAE in 10 men with LUTS, secondary to BPH, by comparing their urinary symptoms, QOL and prostate volume before and 3 months after they underwent PAE in the Radiology Department at SBAH.MethodThe review included the first 10 men who had undergone therapeutic PAE for symptomatic BPH from May 2016 to September 2016. The subjective symptomatic feedback was assessed according to the International Prostate Symptom Score (IPSS) and the Global Quality of Life questionnaire, created by the American Urological Association (AUA). The reduction in the size of the prostate was measured on magnetic resonance imaging (MRI).ResultsEmbolisation was technically achieved in all 10 patients. Bilateral embolisation was performed on nine patients. One patient received unilateral embolisation secondary to unilateral tortuous and atherosclerotic changes of the iliac arteries. Within the 3-month follow-up, the mean IPSS score improved by 15.7 points (p < 0.0039), the mean QOL improved by 4.1 points (p < 0.0039) and the mean prostate volume reduction was 21.8 mL (p < 0.0039). Despite improvements observed, there was one clinical failure. No major complications were reported that increased hospital stay, required hospital readmission or required surgery.ConclusionThe study on the first 10 PAE performed in SBAH concludes that PAE is a safe and effective procedure with favourable short-term follow-up results. This indicates that PAE can safely be offered to patients, who are refractory to medical treatment and not suitable candidates for surgery, in urology departments such as in SBAH.
Highlights
Benign prostatic hyperplasia (BPH) remains a common condition in ageing men, with a prevalence of 50% by the age of 60 years and 90% by the age of 85 years.[1]
Prostate artery embolisation is a relatively new, less invasive procedure offered to men in the Urology Department at Steve Biko Academic Hospital (SBAH), who are refractory to medical treatment and on the waiting list for prostate surgery, provided that there are no contra-indications
The study was a retrospective record review of 10 men who had undergone prostate artery embolisation (PAE) for symptomatic BPH at SBAH in 2016. The aim of this retrospective review was to assess the outcome of PAE for the treatment of lower urinary tract symptoms (LUTS), secondary to BPH, in the first 10 patients treated in the Radiology Department of SBAH in 2016
Summary
Benign prostatic hyperplasia (BPH) remains a common condition in ageing men, with a prevalence of 50% by the age of 60 years and 90% by the age of 85 years.[1] Prostate gland enlargement may cause urethral compression and mechanical bladder outlet obstruction, leading to lower urinary tract symptoms (LUTS). The eighth question assesses the global QOL, with men rating their feelings, should they have to live with their LUTS indefinitely, on a scale of 0 to 6 points, where 0 is delighted and 6 is terrible.[2,4,5,6,7] http://www.sajr.org.za. Benign prostate hyperplasia (BPH) remains a common cause of lower urinary tract symptoms (LUTS) in ageing men in South Africa and can impact significantly on the quality of life (QOL) of these patients. In men with symptomatic BPH, who are refractory to medical treatment, where anaesthesia is contra-indicated because of co-morbidities or transurethral resection of the prostate (TURP) is contra-indicated because of the prostate size, the Urology and Radiology departments at SBAH recently introduced prostate artery embolisation (PAE)
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