Prostatic Artery Embolization for the Treatment of Benign Prostate Hyperplasia: Initial Experience From Bahrain.

ABSTRACT

INTRODUCTION: Benign prostate hyperplasia (BPH) is a common problem in elderly men. The current gold standard is surgical transurethral resection of the prostate (TURP). Prostatic artery embolization (PAE) is an alternative treatment of BPH, which avoids surgical complications. This is a single-center prospective study from the Kingdom of Bahrain to evaluate the effectiveness of PAE. METHODS: This prospective, single-center study included consecutive patients eligible for PAE. Patients were evaluated at one, three, six, and 12 months. Clinical success was defined as a decrease of International Prostate Symptom Score (IPSS) ≥ 3 points, quality of life (QoL) score ≤ 3 or decrease by three points, and no need for surgical intervention. Correlation between prostate-specific antigen (PSA) at 24 hours and reduction in prostate volume and IPSS score was also assessed. RESULTS: A total of 29 patients underwent the procedure between June 2015 and August 2018. Bilateral embolization was achieved in 26 patients. Clinical success was achieved in 26 patients (89.65%). No major adverse events were encountered. Significant improvement for storage (-4.54 ± 2.93, p < 0.005) and voiding symptoms score (-7.54 ± 4.74, p <0.005) were seen. There was no significant correlation between 24 hours PSA and reduction of the size of prostate and IPSS score at 12 months. CONCLUSION: PAE is a minimally invasive procedure that is safe and effective for the management of BPH. PAE is effective for the management of both storage and voiding symptoms.