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J Vasc Interv Radiol ; 27(8): 1115-22, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27321890

ABSTRACT

PURPOSE: To confirm that prostatic artery embolization (PAE) has a positive medium- and long-term effect in symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Between March 2009 and October 2014, 630 consecutive patients with BPH and moderate-to-severe lower urinary tract symptoms refractory to medical therapy for at least 6 months or who refused any medical therapy underwent PAE. Outcome parameters were evaluated at baseline; 1, 3, and 6 months; every 6 months between 1 and 3 years; and yearly thereafter up to 6.5 years. RESULTS: Mean patient age was 65.1 years ± 8.0 (range, 40-89 y). There were 12 (1.9%) technical failures. Bilateral PAE was performed in 572 (92.6%) patients and unilateral PAE was performed in 46 (7.4%) patients. The cumulative clinical success rates at medium- and long-term follow-up were 81.9% (95% confidence interval [CI], 78.3%-84.9%) and 76.3% (95% CI, 68.6%-82.4%). There was a statistically significant (P < .0001) change from baseline to last observed value in all clinical parameters: International Prostate Symptom Score (IPSS), quality-of-life (QOL), prostate volume, prostate-specific antigen, urinary maximal flow rate, postvoid residual, and International Index of Erectile Function. There were 2 major complications without sequelae. CONCLUSIONS: PAE had a positive effect on IPSS, QOL, and all objective outcomes in symptomatic BPH. The medium- (1-3 y) and long-term (> 3-6.5 y) clinical success rates were 81.9% and 76.3%, with no urinary incontinence or sexual dysfunction reported.


Subject(s)
Embolization, Therapeutic/methods , Lower Urinary Tract Symptoms/therapy , Prostate/blood supply , Prostatic Hyperplasia/therapy , Adult , Aged , Aged, 80 and over , Arteries/diagnostic imaging , Brazil , Embolization, Therapeutic/adverse effects , Erectile Dysfunction/etiology , Erectile Dysfunction/physiopathology , Humans , Kallikreins/blood , Kaplan-Meier Estimate , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/etiology , Lower Urinary Tract Symptoms/physiopathology , Male , Middle Aged , Penile Erection , Prostate-Specific Antigen/blood , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnosis , Prostatic Hyperplasia/physiopathology , Quality of Life , Radiography, Interventional , Retrospective Studies , Risk Factors , Severity of Illness Index , Time Factors , Treatment Outcome , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology , Urodynamics
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