Prostate Embolization as an Alternative to Open Surgery in Patients with Large Prostate and Moderate to Severe Lower Urinary Tract Symptoms

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• 作者：Joã ; o Pisco ; MD ; PhD^a ; ^{martinspisco@hslouis.pt" class="auth_mail" title="E-mail the corresponding author} ; Tiago Bilhim ; MD ; PhD ; EBIR^a ; ^c ; Luis C. Pinheiro ; MD ; PhD^b ; L&uacute ; cia Fernandes ; MD^a ; ^c ; Jos&eacute ; Pereira ; MD^a ; ^c ; Nuno V. Costa ; MD^a ; ^c ; Marisa Duarte ; MD^a ; Ant&oacute ; nio G. Oliveira ; MD ; PhD^d
• 关键词：AUR ; acute urinary retention ; BPH ; benign prostatic hyperplasia ; CI ; confidence interval ; HoLEP ; holmium laser enucleation of the prostate ; IIEF ; International Index of Erectile Function ; IPSS ; International Prostate Symptom Score ; LUTS ; lower urinary tract symptoms ; PAE ; prostate artery embolization ; PSA ; prostate-specific antigen ; PV ; prostate volume ; PVA ; polyvinyl alcohol ; PVR ; postvoid residual urine volume ; Qmax ; peak urinary flow rate ; QoL ; quality of life
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：27
• 期：5
• 页码：700-708
• 全文大小：2292 K

文摘

To evaluate efficacy of prostate artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH), prostate volume (PV) > 100 cm³.

c_2">Materials and Methods

This was a single-center retrospective cohort study. Between March 2009 and September 2014, PAE was performed in patients with a diagnosis of BPH, PV > 100 cm³, and moderate to severe lower urinary tract symptoms (LUTS) refractory to medical treatment for at least 6 months or who had acute urinary retention. Success was defined as improved symptoms (International Prostate Symptom Score ≤ 15 and decrease of ≥ 25% from baseline score), improved quality of life (measured as score of ≤ 3 points or decrease of ≥ 1 point from baseline), and no need for additional treatment.

c_3">Results

PAE was performed in 152 patients 48–87 years old (mean ± SD 67.4 y ± 7.5) with mean PV of 134.2 cm³ ± 41.8 (range, 101–383 cm³). PAE was technically successful in 149 patients (98.0%). Symptomatic control was achieved for a median of 18 months ± 15.5 (range, 3–66 mo). There were 33 clinical failures (23.6%); 23 occurred in the short-term (≤ 6 mo), and 10 occurred in the medium-term (6–24 mo); there were no long-term failures (> 36 mo). Cumulative clinical success rates were 90%, 87.9%, 83.5%, 81.1%, and 77.8% at 1, 3, 6, 12, and 18 months and 72.4% thereafter to 66 months (5.5 y).

c_4">Conclusions

PAE provides sustained short-, medium-, and long-term control for LUTS in patients with BPH and PV > 100 cm³.