Evaluation of prostate artery embolization for benign prostatic hyperplasia

This study aimed to evaluate the efficacy and safety of prostate artery embolization (PAE) clinically and radiologically in patients with benign prostatic hyperplasia (BPH) under the consideration of several parameters.

This retrospective single-center study included 133 male patients (mean age: 66.8 ± 8 years) with lower urinary tract symptoms (LUTS) due to BPH that underwent PAE. Outcome parameters and clinical questionnaires allowed a comparison of pre-interventional and post-procedural status of quality of life (QoL), international prostate symptom score (IPSS), international index of erectile function (IIEF) and prostate volume. In addition, this study incorporates the psoas muscle index (PMI) to assess its impact on the outcome of the patients. Technical success and complications were also evaluated.

Technical success was achieved in all cases. All complications were minor and occurred at a rate of 4.5% (6/133). The average follow-up interval following PAE was 17.5 ± 10.9 months. After PAE, the mean prostate volume significantly reduced from 96 ± 26.8 cm³ to 75 ± 26.5 cm³ (p < 0.0001). The mean IPSS significantly reduced from 20.3 ± 5.5 to 12.8 ± 5.2 (p < 0.0001) after PAE. The QoL score was significantly decreased from 4.26 ± 1.08 to 1.98 ± 1.33 (p < 0.0001). The IIEF increased from 19.0 to 20.5 was reported with a nominal significance (p < 0.0001). A robust reciprocal correlation was identified between the IPSS and PMI (ρ = -0.798, p < 0.0001).

Our findings suggest that PAE results in a significant improvement in the maintenance of sexual ability among patients suffering from BPH. Moreover, patients with higher muscle mass, indicated by the PMI, have better clinical outcomes.