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Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium‐ and large‐volume prostates
Author(s) -
Wang Maoqiang,
Guo Liping,
Duan Feng,
Yuan Kai,
Zhang Guodong,
Li Kai,
Yan Jieyu,
Wang Yan,
Kang Haiyan
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13147
Subject(s) - medicine , international prostate symptom score , prostate , lower urinary tract symptoms , urology , hyperplasia , quality of life (healthcare) , cancer , nursing
Objectives To compare the outcomes of prostatic arterial embolization ( PAE ) in treating large (>80 mL ) in comparison with medium‐sized prostate glands (50–80 mL ) to determine whether size affects the outcome of PAE. Patients and Methods A total of 115 patients (mean age 71.5 years) diagnosed with lower urinary tract symptoms ( LUTS ) attributable to benign prostatic hyperplasia ( BPH ) refractory to medical treatment underwent PAE . Group A ( n = 64) included patients with a mean prostate volume of 129 mL ; group B ( n = 51) included patients with a mean prostate volume of 64 mL . PAE was performed using 100‐μm particles. Follow‐up was performed using the International Prostate Symptom Score ( IPSS ), quality of life (QoL), peak urinary flow rate ( Q max ), post‐void residual urine volume ( PVR ), the International Index of Erectile Function short form ( IIEF ‐5), prostate‐specific antigen ( PSA ) and prostate volume measured by magnetic resonance imaging at 1, 3 and 6 months, and every 6 months thereafter. Results There were no significant differences between groups in baseline IPSS , QoL, Q max , PVR , PSA level or IIEF ‐5 score. The technical success rate was 93.8% in group A and 96.8% in group B ( P = 0.7). A total of 101 patients (55 patients in group A and 46 patients in group B) completed the mean (range) follow‐up of 17 (12–33) months. Compared with baseline, there were significant improvements in IPSS , QoL, Q max , prostate volume and PVR in both groups after PAE . The outcomes in group A were significantly better than in group B with regard to mean ± sd IPSS (−14 ± 6.5 vs −10.5 ± 5.5, respectively), Q max (6.0 ± 1.5 vs 4.5 ± 1.0 mL /s, respectively), PVR (−80.0 ± 25.0 vs −60.0 ± 20.0 mL , respectively), prostate volume (−54.5 ± 18.0 mL [−42.3%] vs −18.5 ± 5.0 mL [−28.9%], respectively), and QoL score (−3.0 ± 1.5 vs −2.0 ± 1.0) with P values <0.05. The mean IIEF ‐5 score was not significantly different from baseline in both groups. No major complications were noted. Conclusions We found that PAE is a safe and effective treatment method for patients with LUTS attributable to BPH . The clinical and imaging outcomes of PAE were better in patients with larger prostate glands than medium‐sized ones.