Related Experiment Video
Updated: Dec 3, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Intravesical Prostatic Protrusion Does Not Influence the Efficacy of Prostatic Artery Embolization
Marcio Meira1, André M de Assis2, Airton M Moreira2
1Interventional Radiology Department, Radiology Institute, University of São Paulo Medical School Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
Purpose:
To compare the outcomes of prostatic artery embolization (PAE) in patients with different intravesical prostatic protrusion (IPP) grades.
Materials And Methods:
This retrospective single-center study included 128 patients (aged 50-86 years) who underwent PAE from 2013 to 2017. IPP grades were classified as follows: grade I (<10 mm), grade II (10-19 mm), and grade III (≥20 mm). Nineteen patients (14.8%) had grade I [mean IPP 7.8 mm, prostatic volume (PV) 64.1 cm3], 77 (60.2%) had grade II (mean IPP 14.9 mm, PV 87.0 cm3), and 32 (25%) had grade III (mean IPP 26.2 mm, PV 132.6 cm3), P < .01. The outcomes, including PV, international prostate symptom score (IPSS), and quality of life (QoL), were compared between the IPP grades at the 12-month follow-up. Clinical failure was defined as IPSS >7 or QoL >2.
Results:
IPP decreased (I: -8.2%, II: -27.3%, and III: -38.7%, P = .01), and all other endpoints improved (P < .01). Adjusted covariance analysis, considering baseline PV as a confounding factor, showed no correlation between the 12-month outcomes and baseline IPP. Clinical failure was observed in 17/128 patients (13.3%) and was similar in prevalence among the IPP groups (P = .20). Minor complications occurred in 43 patients (33.6%) and major in 3 (2.3%). There were statistical differences in the complications between IPP grades II and III (P < .01).
Conclusions:
PAE was similarly effective in all the IPP grades at the 12-month follow-up, and there was no difference in the clinical failure between the groups. Complications in IPP grade III were more frequent than those in IPP grade II.
Insights
Prostatic artery embolization (PAE) effectively treats benign prostatic hyperplasia across all intravesical prostatic protrusion (IPP) grades. While outcomes were similar, higher IPP grades saw increased complications, indicating careful patient selection for PAE.
Area of Science:
- Urology
- Interventional Radiology
- Medical Devices
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Intravesical prostatic protrusion (IPP) is a key factor in BPH severity.
- Prostatic artery embolization (PAE) is a minimally invasive treatment for BPH.
Purpose of the Study:
- To compare the effectiveness of PAE in patients with varying degrees of intravesical prostatic protrusion (IPP).
- To assess treatment outcomes and complication rates of PAE based on IPP severity.
- To evaluate the 12-month efficacy of PAE across different IPP grades.
Main Methods:
- Retrospective study of 128 patients undergoing PAE (2013-2017).
- Patients classified into IPP grades I (<10 mm), II (10-19 mm), and III (≥20 mm).
- Comparison of prostatic volume (PV), IPSS, and QoL at 12-month follow-up; clinical failure defined as IPSS >7 or QoL >2.
Main Results:
- PAE led to significant reductions in IPP and improvements in PV, IPSS, and QoL across all grades (P < .01).
- No correlation found between baseline IPP and 12-month outcomes after adjusting for baseline PV.
- Clinical failure rates were similar across IPP grades (13.3%, P = .20); minor complications occurred in 33.6%, major in 2.3%.
Conclusions:
- PAE demonstrates similar efficacy in treating BPH regardless of IPP grade at 12 months.
- Clinical outcomes and failure rates are comparable between different IPP grades following PAE.
- Higher complication rates were observed in patients with IPP grade III compared to grade II.
