Outcomes of Prostate Artery Embolisation in Patients with Severe Symptoms of Benign Prostate Hyperplasia.

Rohana Abdul Rahim,Rozman Zakaria,Nik Azuan Nik Ismail,Goh Eng Hong

doi:10.21315/mjms2021.28.6.6

Abstract

BackgroundBenign prostatic hyperplasia (BPH) is associated with severe lower urinary tract symptoms (LUTS). The severity of LUTS is assessed by the International Prostate Symptoms Score (IPSS). Prostate artery embolisation (PAE) is a newly available method for combating LUTS. This study aims to assess the outcomes of PAE in reducing LUTS and prostate volume in patients with BPH.MethodsPatients diagnosed with BPH with severe LUTS who had undergone PAE were included. Their IPSS score was ≥ 20 despite medical therapy. PAE was performed via the unilateral femoral artery using various types of embolic material. Bilateral or unilateral embolisation of the prostate artery was considered a technical success. The severity of LUTS pre- and post-PAE were assessed using IPSS while prostate volume pre- and post-PAE were assessed by ultrasound and magnetic resonance imaging (MRI).ResultsNinety percent of patients had technical success and one required transurethral resection of the prostate (TURP). The mean IPSS reduction at the final follow-up was 12.9 (P < 0.028). The mean reduction of prostate volume at the last follow-up by ultrasound was 114.99 mL (P < 0.028) and by MRI was 29.17 mL (P < 0.028).ConclusionPAE is safe and effective in reducing severe LUTS and prostate gland volume in BPH patients.

Highlights

Benign prostatic hyperplasia (BPH) occurs in men as young as 40 years old and its growth corresponds with age
In Malaysia, 56% of men with BPH have severe symptoms when assessed by the International Prostate Symptoms Score (IPSS) questionnaire
A BPH symptom score of 0–7 on the IPSS is classified as mild, score of 8–19 is classified as moderate and score of 20–35 is classified as severe (35 is the maximum score)

Summary

Introduction

Benign prostatic hyperplasia (BPH) occurs in men as young as 40 years old and its growth corresponds with age. It is associated with lower urinary tract symptoms (LUTS), which include urgency, nocturia, weak stream of urine, strangury and acute urinary retention. In Malaysia, 56% of men with BPH have severe symptoms when assessed by the International Prostate Symptoms Score (IPSS) questionnaire [1]. A BPH symptom score of 0–7 on the IPSS is classified as mild, score of 8–19 is classified as moderate and score of 20–35 is classified as severe (35 is the maximum score). Benign prostatic hyperplasia (BPH) is associated with severe lower urinary tract symptoms (LUTS). The severity of LUTS is assessed by the International Prostate Symptoms Score (IPSS).

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