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

Our goal was to evaluate the feasibility, safety, and outcomes at 12 months of prostatic artery embolization with Ethylene Vinyl Alcohol Copolymer in patients with benign prostatic hyperplasia-related lower urinary tract symptoms.

This was a single-centre prospective study from November 2023 to November 2024 registered in clinical trials (IDRCB, 2021-AO29-56-35). Twelve consecutive patients were included. Inclusion criteria were an IPSS > 18 or a QoL score > 2, and prostate volume > 40 mL. Exclusion criteria were prostate cancer, advanced atherosclerosis. Outcomes were assessed at 12 months using the International Prostate Symptoms Score and associated quality-of-life score, prostate volume, and post-void residual volume. The overall evolution was analysed using a mixed-effects model with repeated measures.

Bilateral injection was performed in all patients. No patients experienced major adverse events. Compared to baseline, statistically significant improvements were observed at 12 months for the IPSS (9.3 ± 7.8 vs. 17.9 ± 5.8; P = 0.03), IPSS-QoL (2.1 ± 1.9 vs. 4.8 ± 1.1; P = 0.01). No statistically significant improvements were observed at 12 months for post-void residual volume (41.5 ± 54.96 vs. 57.3 ± 61.3; P = 0.9) and prostate volume (82.7 ± 46.6 mL vs. 89.2 ± 34.1 mL; P = 0.6).

Prostatic artery embolization with Ethylene Vinyl Alcohol Copolymer is safe. This method provides good outcomes at 12 months, but no effect on the prostate volume and post-void residual volume. It deserves further evaluation in randomised trials with longer follow-up.

This study was performed according to Good Clinical Practice requirements and the Helsinki Declaration and registered on Clinical Trials.gov (Trial registration: IDRCB, 2021-AO29-56-35. Registered 27 May 2022, http://clinicaltrials.gov/study/NCT05395299?cond=embolization&term&rank=1 ).