Prostatic artery embolization (PAE) is safe and effective for treating benign prostatic hyperplasia, but it is associated with inferior 2-year patient-reported and functional outcomes compared with transurethral resection of the prostate (TURP), according to a recent study.
In a single-center randomized trial that included 103 patients with refractory lower urinary tract symptoms secondary to benign prostatic obstruction, PAE resulted in significantly less improvement in maximum urinary flow rate (Qmax) and less reduction in post-void residual (PVR) urine and prostate volume compared with TURP, Dominik Abt, MD, of the University of St. Gallen in St. Gallen, Switzerland, and colleagues reported in European Urology.
“Improvements of subjective and objective outcomes are superior after TURP, and PAE does not represent a definitive treatment for a relevant proportion of patients,” the authors concluded. “This should be considered for patient selection and counselling.”
At 24 months after treatment, the mean reduction in International Prostate Symptom Score (IPSS) was significantly lower in the PAE than TURP group (9.21 vs 12.09). The mean improvement in Qmax was 3.9 mL/s in the PAE arm compared with 10.23 mL/s in the TURP group. The mean reduction in PVR was significantly less in the PAE than TURP arm (62.1 vs 204 mL). The PAE group experienced a significantly less pronounced mean reduction in prostate volume, as measured by magnetic resonance imaging, compared with the TURP patients (10.66 vs. 30.20 mL).
PAE represents an option for men seeking minimally invasive therapies and who will accept outcomes inferior to those of more invasive surgical treatments, according to the investigators.
Abt D, Müllhaupt G, Hechelhammer L, et al. Prostatic artery embolization versus transurethral resection of the prostate for benign prostatic hyperplasia: 2-yr outcomes of a randomised, open-label, single-centre trial. Published online February 18, 2021. Eur Urol. doi:10.1016/j.eururo.2021.02.008