Two-Year Outcomes of Prostatic Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: An International, Multicenter, Prospective Study

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2024年9月4日

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Marc R. Sapoval,
Shivank Bhatia,
Carole Déan,
Antonio Rampoldi,
Francisco César Carnevale,
Clare Bent,
Charles R. Tapping,
Simone Bongiovanni,
Jeremy Taylor,
Jayson S. Brower,
Michael Rush,
Justin P. McWilliams,
Mark W. Little,
Olivier Pellerin,
Fabiane Barbosa,
Peyman Borghei,
Greg E. Gin,
Edward Uchio,
Adam N. Plotnik,
James H. Briggs,
Andrew MacDonald,
Srini Tummala,
Hemendra Navinchandra Shah,
Issam M. Kably,
Keith Pereira,
James Katrivesis,
Keng Lim Ng,
Kirubahara Vaheesan,
Mina Behdad,
Sarah MacGill,
Sarah Crosbie,
Madita Gavrila,
Susan Anthony,
Lia Quezada,
Ricardo Aleman,
Cynthia Toot Ferguson,
Far Ahmed-Timms,
Alexandra Edwards

摘要

Purpose

To describe clinical outcomes among patients with benign prostatic hyperplasia (BPH) 24 months following prostatic artery embolization (PAE).

Materials and Methods

This was an international, multicenter, prospective trial of males with BPH with lower urinary tract symptoms (LUTS) or acute urinary retention (AUR) treated with PAE. The primary outcome was the 12 month change in the International Prostate Symptom Score (IPSS) for patients referred for bothersome LUTS, or urinary catheter independence for patients treated for AUR. Secondary outcome measures included changes in IPSS at 3 and 24 months, changes in quality of life (QoL), changes in the Sexual Health Inventory for Men (SHIM) questionnaire, technical success rate, and adverse events (AEs). Data were summarized using descriptive statistics.

Results

Four hundred seventy-eight consecutive patients underwent PAE (bothersome LUTS: N = 405; AUR: N = 73), mean age was 70 years. For patients treated for bothersome LUTS, mean total IPSS at baseline was 21.8 and decreased to 9.3, 10.6, and 11.2 at 3, 12, and 24 months following PAE, respectively (all p < 0.001); QoL at baseline was 4.7 and decreased to 2.0, 2.1, and 2.3 at 3, 12, and 24 months, respectively (all p < 0.001). The mean SHIM score at baseline and 12 months following PAE was 13.8 and 13.9, respectively. Of the 73 patients treated for AUR, 48 (65.8%) had their indwelling catheter removed within 3 months of PAE and remained catheter free at 24 months. Fifty-five patients (11.5%) experienced ≥ 1 AE and 10 (2.1%) experienced a serious AE.

Conclusion

PAE is a safe and effective treatment for symptomatic BPH and LUTS.

Level of Evidence Level 3

Trial registration ClinicalTrials.gov NCT03527589.

Graphical Abstract