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Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience.

André Moreira de Assis1, Airton Mota Moreira1, Francisco Cesar Carnevale1

  • 1Interventional Radiology Department, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil.

Radiologia Brasileira
|August 16, 2021
PubMed
Summary

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Prostatic artery embolization (PAE) is a safe and effective treatment for men with enlarged prostates, significantly improving urinary symptoms and quality of life. The procedure demonstrated high technical success rates and minimal complications in a recent study.

Area of Science:

  • Interventional Urology
  • Vascular Radiology
  • Urologic Oncology

Background:

  • Benign prostatic hyperplasia (BPH) affects a large proportion of aging men.
  • Markedly enlarged prostates (≥ 200 cm³), often associated with severe lower urinary tract symptoms (LUTS), present unique treatment challenges.
  • Traditional surgical interventions may carry significant risks for some patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of prostatic artery embolization (PAE) in patients with significantly enlarged prostates.
  • To assess the impact of PAE on clinical, imaging, and urodynamic parameters in this specific patient cohort.

Main Methods:

  • Retrospective analysis of 18 consecutive patients with BPH and prostate volume ≥ 200 cm³ treated with PAE.
  • Patients presented with moderate-to-severe lower urinary tract symptoms.
Keywords:
Embolization, therapeuticLower urinary tract symptomsProstate/blood supplyProstatic hyperplasia/diagnostic imagingQuality of lifeSeverity of illness index

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  • Data collected included technical success, clinical outcomes (International Prostate Symptom Score [IPSS], quality of life), prostate-specific antigen (PSA), peak urinary flow rate, prostate volume, and post-void residual volume.

    • Main Results:

    • PAE achieved technical success in 94.4% of patients.
    • Significant improvements were observed at 3 months post-procedure across all measured parameters (IPSS, quality of life, PSA, flow rate, prostate volume, post-void residual volume; p < 0.05).
    • A low complication rate was noted, with one patient experiencing self-limited hematuria.

    Conclusions:

    • PAE is a safe and effective minimally invasive treatment option for patients with markedly enlarged prostates.
    • The procedure leads to substantial improvements in LUTS, urodynamic function, and prostate gland size.
    • PAE offers a viable alternative for managing BPH in patients with large prostates who may be poor surgical candidates.