Prostatic Arterial Embolization Safe, Effective for BPH

MILAN— Prostatic arterial embolization (PAE) is a safe outpatient procedure for patients with benign prostatic hyperplasia (BPH) and moderate to severe lower urinary tract symptoms (LUTS), data presented at the 28th annual congress of the European Association of Urology suggest.

The procedure is associated with good short and mid-term results, particularly in patients with prostates larger than 100 cc and severe symptoms, according to Luis Campos Pinheiro, MD, of the Faculty of Medical Sciences of the New University of Lisbon in Portugal, and colleagues.

The investigators studied 365 BPH patients with moderate to severe LUTs who underwent PAE. Patients ranged in age from 45-89 years (mean 68.7 years) and prostate volumes ranged from 40-270 cc (mean 89 cc). Seventy-two patients had prostates larger than 100 cc and 42 were in acute urinary retention with a bladder catheter. PAE was performed under local anesthesia. The researchers defined clinical success as a reduction of at least 25% in International Prostate Symptom Score (IPSS) and an IPSS below 15 points and no need for additional medical treatment.

The median follow-up period was 14 months (range 1-42 months). Thirteen patients were lost to follow-up. The patients experienced a mean reduction in IPSS of 10.9 points and a mean prostate volume reduction of 16.2%. The cumulative success rate was 84.9% at three months, 77.2% at 12 months, 74.3% at 24 months, and 74.3% at 36 months. Eight patients subsequently underwent transurethral resection of the prostate and three underwent open prostatectomy.

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