13th Annual Global Embolization Symposium & Technologies
Purpose : The purpose of this study was to investigate the feasibility, safety, and short term efficacy of prostate artery embolization (PAE) in patients with lower urinary tract symptoms (LUTS) due to massive benign prostatic hyperplasia (BPH), defined as prostate volume greater than 200 cc.
Material and Methods : A single center retrospective analysis was conducted on 8 patients with massive prostatic hyperplasia with a mean baseline prostate volume of 323.8 cc (208-653 cc). International Prostate Symptom Score (IPSS), urinary Quality of Life (QoL), and International Index of Erectile Function (IIEF) were collected at baseline, and at clinical follow-up 1-12 months post-procedure. Five of the eight patients were dependent on intermittent self catheterization (n=1) or had an indwelling bladder catheter (n=4). Prostate volume reduction, and improvement in IPSS, QoL, and IIEF scores were analyzed using a non-parametric t-Test.
Results : All patients had technically successful bilateral PAE with no major complications. There was a significant reduction in prostate volumes by 32.0%, with a mean volume reduction of 105.8 cc (p=0.03). At a median follow-up of 6 months: mean IPSS scores after embolization significantly decreased by 76.8%, from an average of 20.5 to 4.8 (p=0.03); mean urinary QoL scores significantly decreased by 66.5%, from an average of 4.2 to 1.4 (p=0.01); mean IIEF scores improved by 14%, from 20.6 to 23.5 (p>0.05). Three of five patients dependent on either an indwelling bladder catheter (n=4) or self-catheterization (n=1), were catheter-free post-procedure. One patient with an indwelling foley catheter transitioned to intermittent self-catheterization.
Conclusions : Bilateral PAE in our cohort of 8 patients with massive BPH greater than 200 cc resulted in a statistically significant reduction in prostate volumes, as well as statistically significant improvements in IPSS and urinary QoL. Our preliminary results suggest that PAE is safe and effective in patients with massive prostates and moderate to severe LUTS, with no apparent upper limit on prostate size.