Prostatic Artery Embolization: An Alternative Treatment for Benign Prostatic Hyperplasia

• Published in: Journal of clinical interventional radiology isvir Vol. 5; no. 2; pp. 091 - 098
• Main Authors: Pike, James F., Abel, William F., Seckel, Tyler B., Schammel, Christine M.G., Flanagan, William, Devane, A. Michael
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.08.2021; Thieme Medical Publishers, Inc
• Subjects: benign prostatic hyperplasia; Original Article; prostate volume >80 ml; prostatic artery embolization; prostatic artery embolization; benign prostatic hyperplasia; prostate volume >80 mL
• ISSN: 2456-4869; 2456-4869
• DOI: 10.1055/s-0041-1730083

Abstract Purpose  Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for patients with prostates >80 mL and has demonstrated lower morbidity rates. We sought to evaluate PAE at a single tertiary medical center. Methods A retrospective review of all patients who underwent PAE was completed. Demographic, clinicopathologic, procedure, and outcome data were collected to include international prostatic symptom score (IPSS) and quality of life (QoL) assessments. Results The pre-PAE mean prostate-specific antigen (PSA) was 8.4 ng/mL, mean prostate volume was 146.9 mL (9% >200 mL), and mean postvoid residual (PVR) was 208.2 mL (21.9% 200–300 mL). IPSS mean was 19.8 and QoL was “mostly dissatisfied.” Following PAE, mean PSA was reduced by 3.2 ng/mL (38.1%, p = 0.3014), the mean prostate volume reduction was 59.2 mL (40.3%, n = 19, p < 0.0001), and the average PVR reduction was 150.3 mL (72.2%, n = 27, p = 0.0002). Average IPSS score was also lower (11.9; 60.1%, n = 25, p < 0.0001) and QoL was reduced to “mostly satisfied” ( p < 0.0001). Technical success was 100% with 24% minor morbidities. Conclusion PAE is a successful treatment for patients with BPH resulting in large prostates that are not good candidates for simple prostatectomy, providing optimal care with less operative and postoperative complications.