Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

BMC Urology

Alexander S. Somwaru¹  Arjun Sharma²  Michael G. Nellamattathil³  Laura M. Flisnik⁴  Venkat S. Katabathina⁵  Stephen Metting⁶ 

[1] Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine At Mount Sinai, 1000 10th Avenue, 10019, New York, NY, USA;Department of Interventional Radiology, Brigham and Women’s Hospital, Boston, MA, USA;Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA;Department of Radiology, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA;Department of Radiology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA;Valley Radiology Medical Associates, San Jose, CA, USA;

关键词: Giant prostatic hyperplasia (GPH);    Prostatic artery embolization (PAE);    Lower urinary tract symptoms (LUTS);   

DOI  :  10.1186/s12894-020-00726-y

来源: Springer

【 摘 要 】

BackgroundPatients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort.MethodsOf 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE.ResultsPatients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred.ConclusionsPAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

【 授权许可】

CC BY