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Comparison of cone-beam CT guided prostatic artery embolization combined with transurethral resection of the prostate
1Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Aim:
To evaluate the safety and efficacy of cone-beam CT (CBCT) guided prostatic artery embolization (PAE) combined with transurethral resection of the prostate (TURP) compared with TURP alone in the management of large-volume (>80 mL) benign prostatic hyperplasia (BPH).
Materials And Methods:
This retrospective propensity score matched study included 99 patients with large-volume BPH treated between January 2017 and June 2023. Thirty-three underwent CBCT-guided PAE followed by TURP, and 66 underwent TURP alone. Perioperative parameters, complication rates, and functional outcomes-including International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual urine (PVR)-were compared between groups at baseline and at 3, 6, 12, and 24 months after surgery.
Results:
The combination group demonstrated significantly shorter operative time (78.9 ± 21.0 vs. 101.4 ± 25.7 min, P<0.001), smaller perioperative hemoglobin decline (10.0 ± 8.6 vs. 15.7 ± 13.3 g/L, P=0.027), shorter bladder irrigation (1.9 ± 0.6 vs. 2.5 ± 0.9 days, P<0.001), and fewer complications (9.1 % vs. 24.2 %, P=0.049). Total hospitalization costs (Chinese Yuan, CNY) did not differ significantly between the two groups (30,231.3 ± 7,946.2 vs.26,514.9 ± 9,954.4, P=0.065). Functional outcomes were significantly better in the combination group from 6 months onward, with lower IPSS and QoL scores, higher Qmax, and reduced PVR at 6, 12, and 24 months (P<0.05).
Conclusion:
CBCT-guided PAE combined with TURP is a safe and effective strategy for large-volume BPH, providing reduced perioperative morbidity and sustained long-term improvements in urinary function compared with TURP alone.
