Abstract
Purpose Traditional urologic surgery of small-volume benign prostatic hyperplasia (BPH) is associated with high failure rates and complications such as bladder neck strictures and contractures. While prostate artery embolization (PAE) is postulated to be effective secondary to gland size reduction, we hypothesize that it may be equally effective in patients with small volume glands. We present our experience of PAE in prostate sizes Material and Methods An Institutional Review Board approved a retrospective study of 78 consecutive PAE patients from January 2011 to July 2014. Patients were evaluated at baseline, 1, 3, and 6 months with the American Urological Association (AUA-SI) symptom index including quality of life-related symptoms (QoL), International Index of Erectile Function (IIEF), and prostate imaging (magnetic resonance imaging, ultrasound, or computed tomography at baseline). Analysis was performed for each stratified group (Group 1, prostate volume 50 cc) individually from baseline to 1, 3, and 6 months and between groups at each follow-up to assess for differences in outcome. Results There were no significant differences in baseline age, AUA score, QoL, or IIEF between groups (mean age 65.2 years, 26.4 AUA, 4.9 Qol, 14 IIEF; n = 78). Baseline volumes were: group 1 (37.5 cc, 25.9 to 48.0 cc, n = 16) and group 2 (108.5 cc, 52.0 to 274.0 cc, n = 62 }. Technical success was achieved in 16/16 patients in Group 1 and 59/62 in Group 2, with 2 unilateral embolizations and 1 unsuccessful secondary to bilateral atherosclerotic occlusion in the latter group. A statistically significant reduction in AUA was achieved in both groups from baseline to 1, 3 and 6 months (n = 77): Group 1: Baseline 27.2 to 12.7, 12.0, and 11.2 at 1, 3, and 6m (p Conclusions PAE appears to offer similar positive clinical benefits to 6 months in patients with small-volume BPH. This may offer crucial benefit to those patients with limited surgical options. Future study aimed at evaluating recurrence rates is suggested.
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