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Prostatic Artery Embolization Using Polyethylene Glycol Microspheres: A 1-Year Follow-up Prospective Study Including
Bruna Ferreira Pilan1, André Moreira de Assis1, Airton Mota Moreira1
1Department of Radiology and Oncology, University of São Paulo Medical School, São Paulo, Brazil.
Purpose:
To evaluate safety and effectiveness of prostatic artery embolization (PAE) using polyethylene glycol (PEG) microspheres in patients with moderate-to-severe benign prostatic hyperplasia (BPH).
Materials And Methods:
A single-center, prospective study of 30 patients who underwent PAE from August 2020 to December 2021 using PEG 400-μm microspheres was conducted. Patient evaluation data using International Prostate Symptom Score (IPSS), quality of life (QoL) score, prostate-specific antigen (PSA), peak urinary flow rate (Qmax), postvoid residual volume (PVR), and prostate volume (PV) at baseline and 3 and 12 months after PAE were obtained.
Results:
Bilateral PAE was performed in all patients. One patient had early clinical failure (3.3%) and another presented with lower urinary tract symptoms (LUTSs) recurrence (3.3%) at the 12-month follow-up. Twenty-eight patients (93.3%) experienced significant and durable LUTS improvement. Mean absolute (and relative) improvement at 3 and 12 months were: IPSS, 14.6 points (-69%) for both; QoL, 3.3 points (-70%) and 3.5 points (-74%); Qmax, 6.3 mL/s (+78%) and 8.6 mL/s (+100%); PSA reduction, 1.2 ng/mL (-22%) and 1.0 ng/mL (-15%); PVR reduction, 48 mL (-56%) and 58.2 mL (-49%); PV reduction, 23.4 cm3 (-29%) and 19.6cm3 (-25%); (P < .05 for all). No major adverse events were observed. Minor adverse events included urinary tract infection (4/30, 13.3%), prostatic tissue elimination (3/30, 10%), penile punctiform ulcer (1/30, 3.3%), and urinary retention (1/30, 3.3%).
Conclusions:
PAE using PEG microspheres was observed to be effective with sustained LUTS improvement at the 12-month follow-up. The incidence of urinary infection and prostatic tissue elimination was higher than previously reported for other embolics.
Insights
Prostatic artery embolization (PAE) with polyethylene glycol (PEG) microspheres effectively improved symptoms for most benign prostatic hyperplasia (BPH) patients. While generally safe, urinary infections and prostatic tissue elimination occurred more frequently than with other embolics.
Area of Science:
- Interventional Radiology
- Urology
Background:
- Benign prostatic hyperplasia (BPH) significantly impacts quality of life.
- Prostatic artery embolization (PAE) is an emerging treatment for BPH.
Purpose of the Study:
- To assess the safety and efficacy of PAE using polyethylene glycol (PEG) microspheres for moderate-to-severe BPH.
Main Methods:
- A prospective study involving 30 BPH patients undergoing PAE with 400-μm PEG microspheres.
- Evaluated outcomes included International Prostate Symptom Score (IPSS), quality of life (QoL), PSA, Qmax, PVR, and prostate volume (PV) at baseline and 3/12 months.
Main Results:
- 93.3% of patients showed significant and durable improvement in lower urinary tract symptoms (LUTSs).
- Statistically significant improvements were observed in IPSS, QoL, Qmax, PSA, PVR, and PV at 12 months.
- No major adverse events occurred; minor events included urinary tract infection and prostatic tissue elimination.
Conclusions:
- PAE with PEG microspheres demonstrates effectiveness in improving BPH symptoms up to 12 months.
- Higher incidences of urinary infection and prostatic tissue elimination were noted compared to other embolic agents.
