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Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia.
BMC Urol. 2020 Oct 08; 20(1):153.BU

Abstract

BACKGROUND

Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort.

METHODS

Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100-250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE.

RESULTS

Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred.

CONCLUSIONS

PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

Authors+Show Affiliations

Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine At Mount Sinai, 1000 10th Avenue, New York, NY, 10019, USA. alex.somwaru@gmail.com.Valley Radiology Medical Associates, San Jose, CA, USA.Department of Radiology, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA.Department of Interventional Radiology, Brigham and Women's Hospital, Boston, MA, USA.Department of Radiology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33032577

Citation

Somwaru, Alexander S., et al. "Prostate Artery Embolization Has Long Term Efficacy for Treatment of Severe Lower Urinary Tract Symptoms From Giant Prostatic Hyperplasia." BMC Urology, vol. 20, no. 1, 2020, p. 153.
Somwaru AS, Metting S, Flisnik LM, et al. Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia. BMC Urol. 2020;20(1):153.
Somwaru, A. S., Metting, S., Flisnik, L. M., Nellamattathil, M. G., Sharma, A., & Katabathina, V. S. (2020). Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia. BMC Urology, 20(1), 153. https://doi.org/10.1186/s12894-020-00726-y
Somwaru AS, et al. Prostate Artery Embolization Has Long Term Efficacy for Treatment of Severe Lower Urinary Tract Symptoms From Giant Prostatic Hyperplasia. BMC Urol. 2020 Oct 8;20(1):153. PubMed PMID: 33032577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia. AU - Somwaru,Alexander S, AU - Metting,Stephen, AU - Flisnik,Laura M, AU - Nellamattathil,Michael G, AU - Sharma,Arjun, AU - Katabathina,Venkat S, Y1 - 2020/10/08/ PY - 2020/05/10/received PY - 2020/09/24/accepted PY - 2020/10/9/entrez PY - 2020/10/10/pubmed PY - 2021/6/4/medline KW - Giant prostatic hyperplasia (GPH) KW - Lower urinary tract symptoms (LUTS) KW - Prostatic artery embolization (PAE) SP - 153 EP - 153 JF - BMC urology JO - BMC Urol VL - 20 IS - 1 N2 - BACKGROUND: Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. METHODS: Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100-250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. RESULTS: Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. CONCLUSIONS: PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments. SN - 1471-2490 UR - https://www.unboundmedicine.com/medline/citation/33032577/Prostate_artery_embolization_has_long_term_efficacy_for_treatment_of_severe_lower_urinary_tract_symptoms_from_giant_prostatic_hyperplasia_ L2 - https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00726-y DB - PRIME DP - Unbound Medicine ER -