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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.
BJU Int. 2016 Jan; 117(1):155-64.BI

Abstract

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 (Qmax), 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, Qmax , 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, Qmax , 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), Qmax (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.

Authors+Show Affiliations

Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25851432

Citation

Wang, Maoqiang, et al. "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." BJU International, vol. 117, no. 1, 2016, pp. 155-64.
Wang M, Guo L, Duan F, et al. 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. BJU Int. 2016;117(1):155-64.
Wang, M., Guo, L., Duan, F., Yuan, K., Zhang, G., Li, K., Yan, J., Wang, Y., & Kang, H. (2016). 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. BJU International, 117(1), 155-64. https://doi.org/10.1111/bju.13147
Wang M, et al. 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. BJU Int. 2016;117(1):155-64. PubMed PMID: 25851432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Wang,Maoqiang, AU - Guo,Liping, AU - Duan,Feng, AU - Yuan,Kai, AU - Zhang,Guodong, AU - Li,Kai, AU - Yan,Jieyu, AU - Wang,Yan, AU - Kang,Haiyan, Y1 - 2015/05/24/ PY - 2015/4/9/entrez PY - 2015/4/9/pubmed PY - 2016/4/26/medline KW - BPH KW - LUTS KW - angiography KW - prostatic arterial embolization SP - 155 EP - 64 JF - BJU international JO - BJU Int VL - 117 IS - 1 N2 - 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 (Qmax), 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, Qmax , 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, Qmax , 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), Qmax (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. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/25851432/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_ L2 - https://doi.org/10.1111/bju.13147 DB - PRIME DP - Unbound Medicine ER -