Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience

Embolização das artérias prostáticas para o tratamento da hiperplasia prostática gigante: experiência de um único centro

Abstract

Objective:

To describe the safety and efficacy of prostatic artery embolization (PAE) in patients with a markedly enlarged prostate.

Materials and Methods:

This was a retrospective study including 18 consecutive patients (mean age, 74 years) with benign prostatic hyperplasia, all with a prostate volume ≥ 200 cm³, who were enrolled to receive PAE for the treatment of moderate-to-severe lower urinary tract symptoms.

Results:

The PAE procedure was technically successful in 17 patients (94.4%). During follow-up, clinical failure (defined as an International Prostate Symptom Score [IPSS] ≥ 8) was observed in two (11.1%) of those 18 patients. At 3 months of follow-up, there was significant improvement over baseline in all relevant outcome measures: total IPSS (from 15.7 to 2.9); IPSS quality of life score (from 5.2 to 1.0); prostate specific antigen (from 11.4 to 1.82 ng/mL); peak urinary flow rate (from 7.45 to 18.6 mL/s); prostate volume (from 252.4 to 151.6 cm³); and post-void residual volume (from 143.7 to 28.3 mL)-p < 0.05 for all. Of the 18 patients, one (5.6%) presented detachment of prostate tissue and self-limited hematuria, which did not require specific treatment.

Conclusion:

In patients with a markedly enlarged prostate, PAE proved to be safe and effective, resulting in significant improvements in clinical, imaging, and urodynamic parameters.

Keywords:
Prostate/blood supply; Embolization, therapeutic; Prostatic hyperplasia/diagnostic imaging; Lower urinary tract symptoms; Severity of illness index; Quality of life