Category: BPH/LUTS: Outcomes & Complications

MP11-18 - Learning from clinical audit: Prostate artery embolisation

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Prostate Artery Embolisation (PAE) represents a unique treatment alternative to surgery in some symptomatic patients with benign prostate hyperplasia (BPH) refractory to medical therapy. PAE potentially evades risk of complications associated with surgery, particularly in elderly men with multiple and/or severe co-morbidities.  We report our experience in a single centre.


Methods :

A prospective cohort of patients considered for PAE between 2014 -2016 were analysed at a tertiary referral centre. Inclusion criteria included symptomatic BPH refractory to medical therapy, haematuria or acute urinary retention. Exclusion criteria included those c considered inappropriate, patient choice and failure to attend for procedure.  Pre and post-procedure parameters were measured including International Prostate Symptom Score (IPSS), Quality of Life (QoL) Qmax, post-residual volume (PVR), prostate specific antigen (PSA), International Index of Erectile Function (IIEF-5) and prostate volume (PV).


Results :

146 patients underwent PAE. Mean age of patients undergoing PAE was 68 (48-90).


Indications for PAE included worsening symptoms 124 (85%), haematuria 11 (7.5%), and acute urinary retention (AUR) 11 (7.5%). 85% underwent bilateral PAE, 13% underwent unilateral PAE and technical failure affect 2% of patients.


Of those patients who underwent PAE for symptomatic BPH, pre-procedure IPSS 22 (2-36), QoL 5(1-6), Qmax 15 (4-44)ml/sec, PVR 180 (20-800)ml, and PV 130 (40-650)cc, PSA 8 (1.5-13) and IIEF-5 14 (1-25). At 24 months IPSS reduced by 10 points (p<0.001), QoL by 2 points (p<0.001). PV reduced by 18% but did not correlate with symptoms change. Qmax, PVR and IIEF, PSA remained unchanged.


Of those patients with AUR and haematuria, 36% voided spontaneously and 64% resolved, respectively. Complications were transient at 12% and included haematuria/haemtospermia, erectile dysfunction, haematoma, retrograde ejaculation, night sweats and temporary faecal incontinence.


Conclusions :

PAE is a safe and successful alternative to surgery in selected patients. Longer term follow-up is required.

Nisha Pindoria

London, England, United Kingdom

Oussama Elhage

Consultant Urological Surgeon
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom

Kathie Wong

Urology Registrar
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom

Sharon Clovis

London, England, United Kingdom

Salma Ghanem

London, England, United Kingdom

Tarun Sabharwal

London, England, United Kingdom

Narayanan Thulasidasan

London, England, United Kingdom

Benjamin Challacombe

Consultant Urological Surgeon
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom

Rick Popert

Consultant Urological Surgeon
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom