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Does Prostate Artery Embolization (PAE) Improve Voiding Symptoms, Storage Symptoms, or Both?

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Prostate artery embolization (PAE) effectively treats both storage and voiding symptoms in benign prostatic obstruction. Storage symptoms, particularly urgency, show significant improvement following PAE, making it a valuable treatment option.

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Area of Science:

  • Urology
  • Interventional Radiology

Background:

  • Benign prostatic obstruction (BPO) significantly impacts quality of life.
  • International Prostate Symptom Score (IPSS) is commonly used to assess BPO symptoms.
  • Previous studies focused on overall IPSS changes after PAE, neglecting symptom-specific improvements.

Purpose of the Study:

  • To investigate the differential impact of PAE on storage versus voiding symptoms.
  • To analyze the extent of improvement in storage symptoms relative to voiding symptoms post-PAE.

Main Methods:

  • Prospective, single-center cohort study of 43 patients undergoing PAE.
  • IPSS was recorded pre-PAE and at 3 and 12 months post-PAE.
  • Paired t-test was used for statistical analysis of symptom scores.

Main Results:

  • Storage symptoms were the predominant issue in 58.1% of patients.
  • Both voiding (13.35 to 5.39) and storage (9.67 to 5.08) symptom scores significantly improved (p < 0.001).
  • Voiding symptoms showed a greater mean improvement per question (1.9 vs. 1.5, p = 0.023), but PAE was highly consistent in improving storage symptoms like urgency (86%).

Conclusions:

  • PAE is an effective treatment for both storage and voiding symptoms in BPO.
  • Storage symptoms, especially urgency, frequency, and nocturia, respond well to PAE.
  • Further comparative studies with surgical interventions are warranted.