Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population

BMC Urology

Research Article

Kai Li¹  Feng Duan¹  Mao Qiang Wang¹  Li Ping Guo¹  Jie Yu Yan¹  Hai Yan Kang¹  Kai Yuan¹  Zhi Jun Wang¹  Yan Wang¹  Guo Dong Zhang¹ 

[1] Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China;

关键词: Angiography;    Benign prostatic hyperplasia (BPH);    Lower urinary tract symptoms (LUTS);    Prostatic artery embolization (PAE);   

DOI  :  10.1186/s12894-015-0026-5

 received in 2014-11-26, accepted in 2015-03-31,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCurrently, large prostate size (>80 mL) of benign prostatic hyperplasia (BPH) still pose technical challenges for surgical treatment. This prospective study was designed to explore the safety and efficacy of prostatic arterial embolization (PAE) as an alternative treatment for patients with lower urinary tract symptoms (LUTS) due to largeBPH.MethodsA total of 117 patients with prostates >80 mL were included in the study; all were failure of medical treatment and unsuited for surgery. PAE was performed using combination of 50-μm and 100-μm particles in size, under local anaesthesia by a unilateral femoral approach. Clinical follow-up was performed using the international prostate symptoms score (IPSS), quality of life (QoL), peak urinary flow (Qmax), post-void residual volume (PVR), international index of erectile function short form (IIEF-5), prostatic specific antigen (PSA) and prostatic volume (PV) measured by magnetic resonance (MR) imaging, at 1, 3, 6 and every 6 months thereafter.ResultsThe prostatic artery origins in this study population were different from previously published results. PAE was technically successful in 109 of 117 patients (93.2%). Follow-up data were available for the 105 patients with a mean follow-up of 24 months. The clinical improvements in IPSS, QoL, Qmax, PVR, and PV at 1, 3, 6, 12, and 24 months was 94.3%, 94.3%, 93.3%, 92.6%, and 91.7%, respectively. The mean IPSS (pre-PAE vs post-PAE 26.0 vs 9.0; P < .0.01), the mean QoL (5.0 vs 3.0; P < 0.01), the mean Qmax (8.5 vs 14.5; P < 0.01), the mean PVR (125.0 vs 40.0; P < 0.01), and PV (118.0 vs 69.0, with a mean reduction of 41.5%; P < 0.01 ) at 24-month after PAE were significantly different with respect to baseline. The mean IIEF-5 was not statistically different from baseline. No major complications were noted.ConclusionsPAE is a safe and effective treatment method for patients with LUTS due to large volume BPH. PAE may play an important role in patients in whom medical therapy has failed, who are not candidates for open surgery or TURP or refuse any surgical treatment.

【 授权许可】

CC BY   
© Wang et al.; licensee BioMed Central. 2015