Efficacy Of Prostatic Artery Embolization Research Articles

Prostate Artery Embolization – Mid to Long-term Outcomes in 1075 Patients

BackgroundTo assess the mid to long-term safety and efficacy of Prostatic Artery Embolization (PAE) at a single-center, cohort of 1075 patients. MethodsThis IRB-approved retrospective-study included patients with moderate-to-severe Lower-Urinary-Tract-Symptoms(LUTS) or urinary-retention who underwent PAE from January-2014 to July-2023. Patients were assessed at 1, 3, 6, and 12-months post-PAE and yearly thereafter. International-Prostate-Symptom-Score(IPSS), Quality-of-Life(QoL) score, International-Index of Erectile-Function–5 score(IIEF-5), Prostate-Specific-Antigen(PSA), Prostate-volume(PV), Post-void-Residual(PVR), Benign-Prostatic-Obstruction(BPO)-medication usage, urinary-catheter status, and further prostate-interventions were assessed. Adverse-events were recorded and classified using the Society of Interventional-Radiology Adverse-Events(SIR-AE) severity classification. ResultsThe mean follow-up was 458.4±559.5 days. Mean age was 70.4±9.0 years, median(IQR) prostate-volume was 107gm(76-150), median pre-procedure IPSS, QoL, IIEF-5, and PSA were 23(18-28), 5(4-6), 17(10-21), and 4.7(2.6-8), respectively. In the LUTS subgroup, at 1-3, 6-12, and 48-60 months, the median-IPSS was 7(4-12, p<0.001), 6(3-11, p<0.001), and 9(4-15, p<0.001). The QoL was 2(1-2, p<0.001), 1(0-2, p<0.001), 2(0-3, p<0.001) at the same time-points. 119(94%) out of 126-patients in the retention cohort were catheter-free at the 3-month follow-up. Ninety-patients(16% of re-intervention eligible patients) required a second prostatic-intervention upto 60-months post-PAE. 65.5% of patients post-PAE were BPO-medication-free at 1-year. 7 patients (0.65%) had SIR-AE severity-Severe: transient ischemic-attacks:3, Urosepsis-2 (treated in inpatient-setting with IV-antibiotics), prostate-sloughing–2(needing TURP). All adverse events resolved without sequelae. ConclusionIn a large cohort with long-term longitudinal follow-up, PAE shows significant, sustained long-term relief of LUTS, improved QoL, low re-intervention rate, and high BPO medication-free rates. 94% of catheter-dependent patients at baseline were catheter-free at 3-months.

Analysis of the efficacy of Prostatic Artery Embolization in the treatment of Benign Prostatic Hyperplasia.

To investigate the safety and efficacy of prostatic artery embolization (PAE) in the treatment of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), and to investigate predictors of clinical success of PAE. A retrospective analysis was used to collect 107 patients [median age 81.0 (73.0,85.0)] with BPH-related LUTS treated with PAE from September 2014 to February 2022 in a hospital. Repeated measurement ANOVA was used to compare the efficacy evaluation indicators at different times before and after PAE. Univariate and multivariate analyses were used to identify potential predictors of PAE clinical success and establish the optimal joint prediction model. The Receiver Operating Characteristic curves of the quantitative predictors and multivariate model prediction probability values significantly correlated with clinical success were plotted. Of the 107 cases, 103 (96.3%) successfully underwent PAE. The International Prostate Symptom Score (IPSS) decreased from a baseline mean of 24.94 to 10.19 (P < 0.05) 3 months after PAE, and the mean IPSS at 6 months, 12 months and 24 months was 10.12, 11.30 and 11.86, respectively, which were statistically significant compared with baseline (P<0.05). Predictors of clinical success were greater prostate volume (> 65 ml, P = 0.018), adenomatous-dominant benign prostatic hyperplasia (AdBPH)(P = 0.030), indwelling catheterization due to urine retention (P = 0.028), and bilateral embolization (P = 0.018). PAE was able to significantly improve BPH-related LUTS and the outcome indicators remained stable at long-term follow-up. Preoperative urinary retention catheters, AdBPH, larger prostate volume (> 65ml) and bilateral embolization suggest better clinical efficacy.

The Efficacy of Prostatic Artery Embolization (PAE) as Palliative Therapy in Prostate Cancer

Introduction: Prostate cancer, the primary contributor to cancer-related fatalities in Western countries, predominantly impacts individuals between the ages of 45 and 60. The World Health Organization (WHO) has documented 1,414,259 new cases worldwide. Diagnosis methods include prostate biopsy, PSA testing, and MRI, with risk factors such as age, weight, race, and family history contributing to the varied epidemiology of the disease. Treatment alternatives such as surgery and radiation therapy come with notable side effects, prompting ongoing research into alternatives like prostate artery embolization (PAE) for benign prostatic obstruction. However, the role of PAE in patients with prostate cancer remains uncertain. Aim: The purpose of this systematic review is to determine the efficacy of Prostatic Artery Embolization as one of the palliative management strategies for clinical outcomes in prostate cancer. Method: We searched for English-language full-text literature from Pubmed, Cochrane, Wiley Library, Proquest, SpringerLink, and ScienceDirect databases from January 2013 to Desember 2023. Based on the 1442 journals identified in this study, the number of evaluated articles is 6. Results: In six studies, PAE induces tissue ischemia through femoral artery embolization, offering promise for localized prostate cancer treatment. Administered under local anesthesia, PAE has shorter hospital stays and is well-tolerated compared to TURP. After PAE treatment, significant IPSS reduction occurred, with improved outcomes reported at 1 and 6 months. Histopathology showed necrotic zones, but viable cancer cells persisted. PAE is a valuable adjunctive therapy for reducing organ-at-risk doses in exclusive prostate radiation therapy. Conclusion: PAE is a minimally invasive treatment for LUTS related to BPH and its potential in managing PCa. PAE, utilizing femoral artery occlusion, shows significant short and medium-term reductions in IPSS. While there's notable success in PCa management and reduced radiation doses, further research is essential for a comprehensive understanding of PAE's efficacy in localized PCa treatment.

Efficacy of Prostatic Artery Embolization in Symptomatic Benign Enlargement of Prostate (&gt;100 cc): A Hospital-based Prospective Study in a Tertiary Care Center

Abstract Background: Prostatic artery embolization (PAE) has recently emerged as an effective minimally invasive procedure for the treatment of patients with symptomatic benign enlargement of prostate (BEP). Aim and Objective: The objective of the study was to evaluate the efficacy of PAE in BEP patients. Materials and Methods: A prospective observational clinical study was conducted at tertiary care hospital over 1-year from April 2022 to March 2023. This study included patients with lower urinary tract symptoms indicative of BEP and a prostate volume of 100 cc or more. The primary endpoints of the study were determining the International Prostate Symptom Score (IPSS), Q-max, prostate volume, intraprostatic resistive index, and prostate-specific antigen (PSA). Results: A total of 21 patients, with a mean age of 72 years were included in the study. After a 6-month follow-up, 15 patients were catheter-free, while 6 patients required adjunctive surgical treatment in the form of transurethral resection of prostate or holmium enucleation of prostate. The mean IPSS significantly decreased from 22 to 8 after PAE (P = 0.0394 Mean Q-max significantly increased from 8 mL/s to 16 mL/s (P = 0.05), while prostate volume decreased significantly at 6 months’ follow-up (122.0 cc vs. 58.0 cc, P = 0.0334). Intraprostatic resistive index showed a statistically significant increase after embolization of unilateral/bilateral prostatic arteries. 0.62 versus 1.34, P = 0.0317, and serum PSA values were comparable pre- and post- PAE. Conclusion: PAE effectively treats symptomatic BEP with a prostatic volume of 100cc or more, achieving a success rate of 71.5% with improvements in IPSS, increased Q-max values, and reduced prostate size.

A correlation study between prostate necrosis rate calculated by 3D Slicer software and clinical efficacy of prostatic artery embolization, along with an analysis of predictors of clinical success after prostatic artery embolization.

To analyze the correlation between the prostate necrosis rate at 1-month after prostatic artery embolization (PAE) and the clinical efficacy at 1-year after PAE, and to explore potential predictors of clinical success after PAE for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). The prostate magnetic resonance imaging data at 1-month after PAE were imported into 3D Slicer software for calculating the prostate necrosis rate and thus analyzing the relationship between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after PAE. The 151 patients with PAE technical success were divided into a clinical success group (n = 126) and a clinical failure group (n = 25). Independent predictors of clinical success after PAE were analyzed by multifactorial logistic regression, and the predictive performance of each factor was evaluated by applying the receiver operating characteristic curve and the area under the curve (AUC). There was a linear negative correlation between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after surgery (P < 0.001). In the clinical success group, both the initial prostate volume (PV) and the prostate necrosis rate at 1-month after PAE were significantly higher than in the clinical failure group (P < 0.001), and acute urinary retention (AUR) and adenomatous-dominant BPH were also associated with clinical success (P < 0.05). Multifactorial logistic regression analysis revealed that larger initial PV, a higher prostate necrosis rate at 1-month after surgery, and AUR were independent predictors of clinical success after PAE. The AUC values for these three indicators and their combination were 0.720, 0.928, 0.599, and 0.951, respectively, in which the prostate necrosis rate at 1-month after PAE demonstrating a high predictive value. The higher the prostate necrosis rate at 1-month after PAE, the better the clinical efficacy at 1-year after PAE is likely to be, and the prostate necrosis rate at 1-month after PAE is expected to become a predictor of clinical success after PAE.

One-year outcomes after prostate artery embolization versus laser enucleation: A network meta-analysis.

Although holmium laser enucleation (HoLEP) is considered a size-independent procedure for treatment of an enlarged prostate, prostate artery embolization (PAE) is emerging as an alternative modality to treat moderate and large benign prostatic hyperplasia. This study aims to compare the early post-operative and short-term efficacy of PAE and HoLEP. PubMed, Cochrane Library and EMBASE databases were searched. Network meta-analysis was performed following PRISMA-N-guidelines. Post-operative parameters analysed include international prostate symptom score (IPSS), quality of life (QOL), post-void residual urine (PVR), maximal uroflow rate (Qmax) and serious adverse events (SAE). Random effects model calculated weighted mean differences (WMD). If 95%CI crossed the line of no effect (WMD =0), evidence indicated no statistically significant difference between treatments compared. Qualitative and quantitative syntheses included 20 and 18 studies with 1991 and 1606 patients, respectively. At 3months, there was no statistically significant difference between PAE and HoLEP in IPSS score improvement [WMD: -2.21: 95%CI: (-10.20, 5.78), favouring PAE], QoL score improvement [WMD: -0.22:95%CI: (-1.75, 1.32), favouring PAE] and PVR improvement [WMD: 26.97: 95%CI: (-59.53, 113.48), favouring HoLEP]. However, PAE was found inferior to HoLEP for Qmax improvement [WMD: 8.47, 95%CI: (2.89, 14.05), favouring HoLEP]. At 1-year follow-up, there was no statistically significant was found between PAE and HoLEP for IPSS score improvement [WMD:6.03, 95%CI: (-1.30, 13.35)], QoL score improvement [WMD: 0.03, 95%CI: (-1.19, 1.25)], PVR improvement [WMD:4.11, 95%CI: (-32.31, 40.53)] and Qmax improvement [WMD:2.60, 95%CI: (-2.20, 7.41)] with all differences favouring HoLEP. PAE was superior to HoLEP for SAE [PAE vs. HoLEP-OR: 0.68, 95%CI: (0.25, 1.37)]. HoLEP was superior to PAE at 3months for Qmax improvement. There was no significant difference in IPSS, QoL, PVR and Qmax improvement at 1year between PAE and HoLEP. PAE was also associated with lesser SAE compared to HoLEP. Studies on the long-term outcome of PAE are needed to establish the durability of early outcomes after PAE.

Prostatic Artery Embolization as a Treatment Option for Symptomatic Benign Prostatic Hyperplasia: Results from the Prospective Follow-Up Study in Lithuania.

Background: The endovascular treatment of symptomatic benign prostate hypertrophy (BPH) by prostatic artery embolization (PAE) is one of the new treatments proposed. PAE is a minimally invasive alternative that has been shown to successfully treat lower urinary tract symptoms in BPH patients by causing infarction and necrosis of hyperplastic adenomatous tissue, which decompresses urethral impingement and improves obstructive symptoms. The aim of this study was to evaluate the effectiveness and efficacy of PAE in relieving symptoms in patients with symptomatic BPH. Materials and Methods: The material for the study was collected from 2019 to 2022. A total of 70 men with BPH and PAE were studied. Patients underwent an urological examination to measure the International Prostate Symptom Score (IPSS), Quality of Life score (QoL), International Index of Erectile Function short form (IIEF-5), uroflowmetry with Qmax, prostatic volume (PV), and post-void residual volume (PVR) measurements. Statistical analysis for dependent samples was applied. Measured parameters at 2 months and 6 months follow-up were compared to baseline. Results: At baseline, the age of the male (N = 70) subjects was 74 ± 9.6 years with a median of 73.8, but fluctuated from 53 to 90 years. The mean of PV was almost 111 mL and the Qmax was close to 7.7 mL/s. The average PVR was 107.6 mL. The IPSS score mean was 21.3 points and the QoL score was 4.53 points. The IIEF-5 questionnaire score was almost 1.8 points, which shows severe erectile dysfunction. The mean value of the PSA level was 5.8 ng/mL. After 2 and 6 months of PAE, all indicators and scores except erectile function significantly improved. Conclusions: The outcomes of our study show promising results for patients with benign prostatic hyperplasia after PAE. The main prostate-related parameters (PV, Qmax, PVR, IPSS) improved significantly 6 months after embolization.

Safety and efficacy of prostatic artery embolization in patients with hematuria due to benign prostate hyperplasia

BackgroundBenign prostate hyperplasia (BPH) commonly affects aging men that can result in hematuria. For patients who are not suitable candidates for surgery, prostatic artery embolization (PAE) has emerged as a minimally invasive alternative. This study aimed to assess the safety and efficacy of PAE specifically for treating hematuria in BPH patients who cannot undergo surgery.MethodsThe study included n = 110 participants. PAE was performed, and outcomes of interest, including resolution of hematuria, improvement in lower urinary tract symptoms (LUTS), prostate volume (PV), and quality of life (QoL), were assessed. Adverse events were also analyzed.ResultsThe study demonstrated a 100% clinical success rate in resolving hematuria at 3 months, with no recurrence observed during the 6-month follow-up. Mean hemoglobin levels increased, indicating successful resolution of bleeding. PAE also led to a significant reduction in LUTS severity, as measured by the International Prostate Symptom Score (IPSS). Improvement in the mean maximum urinary flow rate (Qmax) indicated enhanced urinary flow. Additionally, MRI measurements showed a reduction in prostate volume following PAE. These improvements contributed to enhanced QoL for the patients.ConclusionsProstatic artery embolization (PAE) was found to be a safe and effective treatment option for hematuria in BPH patients not suitable for surgery. PAE demonstrated a high success rate in resolving hematuria and resulted in significant improvements in LUTS, prostate volume, and QoL outcomes. These findings have important implications for clinical decision-making and improving patient care for BPH patients with hematuria. Further research and long-term follow-up studies are necessary to validate these findings and assess the durability of PAE outcomes in this patient population.

Abstract No. 509 Safety and Efficacy of Prostate Artery Embolization Utilizing n-BCA Glue

Abstract No. 509 Safety and Efficacy of Prostate Artery Embolization Utilizing n-BCA Glue

SC154 - Efficacy of prostate artery embolization in patients with indwelling bladder catheter

SC154 - Efficacy of prostate artery embolization in patients with indwelling bladder catheter

Long-Term Efficacy and Recurrence Prediction of Prostatic Artery Embolization for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

To explore the efficacy of prostatic artery embolization (PAE) for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) during long-term follow-up and analyze predictors related to LUTS recurrence. This was a single-center retrospective study involving 125 BPH patients with LUTS who underwent PAE from February 2014 to February 2020. The median follow-up was 36months. Clinical success was defined as reductions in the International Prostate Symptom Score (IPSS) and quality of life (QoL) score and no need for any other treatment for LUTS; otherwise, it was regarded as a clinical failure. Recurrence was defined as a clinical failure that occurred after an initial success. Cumulative clinical success rates, recurrence rates and re-intervention rates were evaluated. Friedman test was performed to compare differences in IPSS, QoL and prostatic volume (PV) among baseline and follow-up times. Predictors for LUTS recurrence were analyzed with the univariate and multivariate Cox regression model. Technical success (bilateral PAE) rate was 92.8% (116/125). Significant differences in IPSS, QoL and PV were observed between baseline and follow-up time points (P < 0.001). The cumulative clinical success rates at 2, 3, 4 and 5years were 82.4%, 65.5%, 52.4% and 37.4%. The cumulative recurrence rates and re-intervention rates at 1, 2 and 5years were 6.8%, 12.7%, 60.4% and 5.9%, 10.2%, 50.8%, respectively. Unilateral PAE was an significant predictor of recurrence (P < 0.05). PAE is an effective treatment option for LUTS. Unilateral PAE is a significant independent predictor of LUTS recurrence.

Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients

PurposeTo evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).Materials and methodsThis multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien–Dindo classification.ResultsTechnical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P < .01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P < .01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P < .05) at 12 months. Minor complications (Clavien–Dindo grades I–II) occurred in 13.6% of patients, without major complications observed.ConclusionPAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcomes.

Abstract No. 64 Prostate artery embolization in prostate size less than 80 g: a single-center experience with 5 years of follow-up

To evaluate the safety and efficacy of prostate artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia (BPH) for prostates < 80 g

Abstract No. 67 Prostate artery embolization in patients with prostate glands greater than 80 g: a single-center experience with 5 years of follow-up

To evaluate the safety and efficacy of prostate artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia (BPH) for prostate glands greater than 80 g, a cohort of patients limited in management options given the size of the prostate

Abstract No. 514 Salvage prostate artery embolization in patients with refractory lower urinary tract symptoms following prior minimally invasive surgical technique for benign prostate hyperplasia

Minimally invasive surgical techniques (MIST) are alternatives to transurethral resection of the prostate (TURP) for treatment of Benign Prostatic Hyperplasia (BPH)1. However, a significant number of patients have persistent symptoms requiring further treatment. The efficacy of prostate artery embolization (PAE) following TURP for treatment of refractory lower urinary tract symptoms (LUTS) has been previously reported2,3. The purpose of this study was to report the safety and efficacy of PAE following MIST for refractory LUTS.

Prostatic artery embolization in people with spinal cord injury: a safe and effective technique to ease intermittent catheterization in case of concomitant benign prostatic hyperplasia.

Case series. To assess the safety and efficacy of prostatic artery embolization (PAE) to reduce prostate volume (PV) and facilitate intermittent catheterization (IC) in individuals with concurrent benign prostatic hyperplasia (BPH) and spinal cord injury (SCI). Italian tertiary referral center for people with SCI. We retrospectively collected all data of individuals undergoing PAE from 2015 to 2020 because of BPH-related problems during IC. PAE was performed under local anesthesia with superselective catheterization of the prostatic arteries. Technical success was defined as bilateral embolization. We determined pre- and post-procedural PV by magnetic resonance imaging. We considered 10 cases with tetraplegia (n = 5) and paraplegia (n = 5). Nine (90%) procedures were technically successful, while we performed monolateral PAE in one case. The median pre-procedural PV was 61 mL. After 6 months, all patients experienced significant PV reduction (median: 19.6%), and 7/7 patients with indwelling urinary catheter started successfully IC. Neither intra- nor post-procedural complications occurred within a median follow-up of 33 months. PAE proved to be a safe and effective treatment for BPH to facilitate IC in people with SCI. Considering the minimal morbidity of PAE, further multi-center studies are mandatory to draw definitive conclusions and warrant its widespread adoption in this population.

Abstract No. 59 Prostate artery embolization in prostate size larger than 80 g: a single-center experience with 5-year follow up

To evaluate the safety and efficacy of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) for prostates > 80 g. 381 patients underwent PAE for BPH with prostate size > 80 g from April 2014 to June 2020 were evaluated as part of an IRB-approved retrospective analysis at a single institution. 206 patients met inclusion criteria. Mean patient age was 70.7 ± 9.7 years, mean prostate volume was 143.1 ± 66.0 g, median (IQR) pre-procedure IPSS, QOL and PVR were 23.0 (IQR 10.0), 5.0 (IQR 2.0) and 156.0 (IQR 230.3) mL. Clinical and urodynamic outcomes were reviewed at 3, 6, and 12 months following PAE. Adverse events were recorded using the Clavien-Dindo classification. At 3 months median IPSS was 6.0 (IQR 7.0) (n = 178, P< 0.0001), median QOL was 1.0 (IQR 2.0) (n = 191, P< 0.0001), median PVR was 50.0 mL (IQR 82.7) (n = 44, P< 0.0001), mean prostate size was 94.5 g (n = 206, P< 0.0001). Six months after PAE, median IPSS was 5.0 (IQR 8.0) (n = 133, P< 0.0001), median QOL was 1.0 (IQR 2.0) (n = 136, P< 0.0001), median PVR was 43.0 mL (IQR 143.0) (n = 30, P = 0.001). At 12 months median IPSS was 5.0 (IQR 8.0) (n = 109, P< 0.0001), median QOL was 1 (IQR 2) (n = 110, P< 0.0001), median PVR was 103.5 mL (IQR 149.5) (n = 20, P = 0.002), and mean prostate size was 98.2 g (↓35%, n = 71, P< 0.0001). At 24 months, median IPSS was 8.0 (IQR 11.2) (n = 24, P< 0.0001), median QOL was 1.0 (IQR 3.0) (n = 23, P< 0.0001), and median prostate size was 109.3 g (↓29%, n = 20, P< 0.0001). At 36 to 60 months median IPSS was 6.0 (IQR 10.5) (n = 23, P< 0.0001), median QOL was 1 (IQR 2) (n = 24, P< 0.0001), and mean prostate size was 136.2 g (↓30%, n = 5, P = 0.09). 4 grade II or above complications occurred, urosepsis (n = 3) and stroke (n = 1), all other complications were self-limited grade I. PAE achieved a clinically and statistically significant improvement in lower urinary tract symptoms and secondary outcome measures in patients with prostates > 80g. PAE is an effective treatment for BPH with long-term sustained benefits.

Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients.

ObjectiveTo assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia.MethodsTwenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level.ResultsSelective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%.ConclusionsPAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.

Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience.

ObjectiveTo describe the safety and efficacy of prostatic artery embolization (PAE) in patients with a markedly enlarged prostate.Materials and MethodsThis was a retrospective study including 18 consecutive patients (mean age, 74 years) with benign prostatic hyperplasia, all with a prostate volume ≥ 200 cm3, who were enrolled to receive PAE for the treatment of moderate-to-severe lower urinary tract symptoms.ResultsThe PAE procedure was technically successful in 17 patients (94.4%). During follow-up, clinical failure (defined as an International Prostate Symptom Score [IPSS] ≥ 8) was observed in two (11.1%) of those 18 patients. At 3 months of follow-up, there was significant improvement over baseline in all relevant outcome measures: total IPSS (from 15.7 to 2.9); IPSS quality of life score (from 5.2 to 1.0); prostate specific antigen (from 11.4 to 1.82 ng/mL); peak urinary flow rate (from 7.45 to 18.6 mL/s); prostate volume (from 252.4 to 151.6 cm3); and post-void residual volume (from 143.7 to 28.3 mL)-p < 0.05 for all. Of the 18 patients, one (5.6%) presented detachment of prostate tissue and self-limited hematuria, which did not require specific treatment.ConclusionIn patients with a markedly enlarged prostate, PAE proved to be safe and effective, resulting in significant improvements in clinical, imaging, and urodynamic parameters.

Prostatic Artery Embolization for the Treatment of Recurrent Lower Urinary Tract Symptoms following Transurethral Resection of the Prostate

PurposeTo evaluate the safety and efficacy of prostatic artery embolization (PAE) in patients with recurrent lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) who underwent a previous transurethral resection of the prostate (TURP). Materials and MethodsThis retrospective study analyzed 15 of 19 patients who underwent PAE for recurrent LUTS after TURP between February 2014 and April 2019. The technical and clinical success rates and complications related to the procedure were recorded. International Prostate Symptom Score (IPSS), quality of life (QoL), and prostatic volume (PV) were evaluated at baseline and 3- and 12-mo follow-up. ResultsThe intervals from TURP to recurrent symptoms and from TURP to PAE were 4.3 y ± 3.2 and 5.6 y ± 3.8, respectively. Technical success was achieved in all patients. The clinical success rate for LUTS relief at 12 mo was 93.3% (14 of 15). IPSS significantly reduced from 22.5 ± 4.1 at baseline to 9.9 ± 4.9 at 12-mo follow-up, and QoL score improved from 4.7 ± 1.0 to 2.1 ± 1.1 (P < .05 for both). There was a significant mean reduction of 26.6% in PV at 12 mo, improving from 100.7 cm3 ± 38.5 to 73.9 cm3 ± 29.4 (P < .05). No severe complications were encountered. ConclusionsPAE may be a safe and effective treatment option for the management of recurrent LUTS secondary to BPH in patients who have previously undergone TURP.