Prostatic artery embolisation for the treatment of lower urinary tract symptoms and catheter-dependent urinary retention in patients with benign prostatic hyperplasia
BAUS ePoster online library. Fadel M. Jun 27, 2018; 211364; P8-3
Dr. Michael Fadel
Dr. Michael Fadel
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Abstract
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Introduction: Medical and surgical treatments for benign prostatic hyperplasia (BPH) can be effective but are associated with limitations. We report the outcomes of an emerging technique of prostate artery embolisation (PAE).

Methods: 46 patients (mean age 74 years) with BPH treated with PAE in a single institution were analysed retrospectively (mean follow-up 18 months). All patients were evaluated by digital rectal examination, prostate-specific antigen, transrectal ultrasound (TRUS) and computed-tomography angiogram. PAE was performed using 300-500μm embospheres, under local anaesthesia by unilateral/bilateral femoral approach. Clinical follow-up included post-void residual volume (PVR), prostatic volume (PV) using TRUS, International Prostate Symptom Score (IPSS), quality of life (QoL) and peak urinary flow (Qmax) recorded at 1, 3, 6 and 12 months.

Results: Urinary retention (63.3%) and lower urinary tract symptoms (36.7%) were the most common indications for PAE. 72% of patients were catheter-free at 1 month and 67% had complete resolution of symptoms at 6 months. Bilateral PAE was performed in 83.3% of cases. The mean PVR (pre-PAE vs post-PAE 410.4ml vs 131ml; p<0.05), mean PV (144.0ml vs 80.2ml, with a mean reduction of 44.3%; p<0.05), mean IPSS (13.0 vs 5.3; p<0.05), mean QoL (5.5 vs 1.3; p<0.05) and mean Qmax (7.8ml/s vs 12.9ml/s; p<0.05) were significantly different with respect to baseline. There were no major complications reported.

Conclusions: PAE is an effective and minimally-invasive alternative for the treatment of BPH, which should be considered in medically refractory BPH and in patients who are not candidates for transurethral resection of the prostate or prostatectomy.
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