Evaluation of prostatic artery embolization efficiency in benign prostatic hyperplasia patients withhigh comorbidity

Abstract

Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity.

Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE.

Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia.

Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.