Evaluation of Prostatic Artery Embolization Efficiency in Benign Prostatic Hyperplasia Patients with High Comorbidity

Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: İsmail Okan Yıldırım MD, İnönü University Faculty of Medicine, Department of Radiology, Malatya, Turkey Phone: +90 422 341 06 60/5707 E-mail: ioyildirim@gmail.com ORCID-ID: orcid.org/0000-0002-3641-0103 Re cei ved: 28.11.2017 Ac cep ted: 25.12.2017 Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index ≥2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm3 were included. Total PSA, maximum flow rate (Qmax), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86±6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18±6.75 an d 11.27±3.29 (p<0.05), Qmax: 8.31±3.12 and 17.22±3.23 (p<0.05), PVR: 87.9±19.25 and 25.86±7.72 (p<0.05), TPV: 134.45±57.56 and 86±15.4 (p<0.05), and PSA: 3.89±1.26 and 2.11±1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.