Prostatic Artery Embolization Using Ethylene Vinyl Alcohol (EVOH) Copolymer for Benign Prostatic Hyperplasia:...

Area of Science:

• Interventional Urology
• Vascular Interventional Radiology

Background:

• Benign prostatic hyperplasia (BPH) causes lower urinary tract symptoms (LUTS).
• Prostatic artery embolization (PAE) is an emerging treatment for BPH.
• Ethylene Vinyl Alcohol Copolymer (EVOH) is a potential embolic agent for PAE.

Purpose of the Study:

• To evaluate the feasibility, safety, and 12-month outcomes of PAE with EVOH for BPH-related LUTS.
• To assess the impact of PAE on International Prostate Symptoms Score (IPSS), quality of life (IPSS-QoL), prostate volume, and post-void residual (PVR) volume.

Main Methods:

• A single-center prospective study included 12 consecutive patients with moderate to severe LUTS and enlarged prostates (volume > 40 mL).
• Patients with prostate cancer or advanced atherosclerosis were excluded.
• Outcomes were assessed at 12 months using IPSS, IPSS-QoL, prostate volume, and PVR volume. Data were analyzed using a mixed-effects model.

Main Results:

• Bilateral PAE with EVOH was technically successful in all patients, with no major adverse events.
• Statistically significant improvements were observed at 12 months for IPSS (17.9 to 9.3, P=0.03) and IPSS-QoL (4.8 to 2.1, P=0.01).
• No significant changes were noted in PVR volume (57.3 to 41.5 mL, P=0.9) or prostate volume (89.2 to 82.7 mL, P=0.6).

Conclusions:

• PAE with EVOH is a safe treatment option for BPH.
• The procedure demonstrates efficacy in improving LUTS and quality of life at 12 months.
• Further randomized trials with longer follow-up are warranted to confirm these findings and evaluate long-term effects on prostate and PVR volumes.