SAN FRANCISCO, CA USA (UroToday.com) - Purpose: To confirm the safety of prostatic artery embolization (PAE), as an outpatient procedure, in a large series of patients with symptomatic benign prostatic hyperplasia (BPH).
Materials: One hundred fifty-two patients with symptomatic BPH, after failure of medical treatment for at least 6 months, were selected to prostatic artery embolization (PAE). Ages ranged between 47 and 85 years (mean 72.6 years). Eighteen patients had urinary retention with bladder catheter. Eight patients had had partial prostatectomy prior. Prostate volume, PSA, uroflowmetry (peak urinary flow and PVR - post voiding residual volume), IPSS (International Prostate Symptom Score), and IIEF (International Index Erectile Function) were evaluated before PAE, at 1, 3, 6 and every 6 months thereafter. The mean prostate volume before PAE was 84.6cc. Technical success was considered when at least one prostatic artery was embolized. The control follow-up was performed between 1 and 30 months (mean 9.4 months) after PAE.
Results PAE was technically successful in 144 of the 152 patients (94.7%) and the embolization was bilateral in 135 patients (93.8%). One hundred two patients of the total of 152 were followed up between 3 and 30 months. All patients were evaluated at 1 and at 3 months, 74 patients at 6 months, 46 at 12 months, 16 at 18 months and 10 between 24 and 30 months. There was clinical success at 3 months in 86 of the 102 patients (84.3%), at 6 months in 60 of 74 patients (81.1%) at 12 months in 38 of 46 patients (82.6%), at 18 months in 13 of 16 patients (81.3%) and between 24 and 30 months in 7 of 10 patients 70%. There was one case of major complication, a 1.5 cm squared sized of bladder wall ischaemia that was treated by surgical removal. With respect to minor complications, there were reported sensations of burning in urethra, urinary infection, haematuria, hemospermia, balanoprotastites, rectorragias, inguinal hematoma and pain. The rate of complications did not increase in the patients treated on an outpatient basis.
Conclusions: Further evaluation of PAE in a large series of patients with symptomatic BPH and failure of medical therapy confirms the safety as an outpatient procedure and the good short and medium term results.
Presented by Joao-Martins Pisco, MD* at the 37th Annual Scientific Meeting of the Society of Interventional Radiology (SIR) - March 24 - 29, 2012 - Moscone Center - San Francisco, CA USA
*Hospital Saint Louis
Lisbon, Portugal
View SIR 2012 Annual Meeting Coverage
