Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia
Abstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Urology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12894-020-00726-y |
| _version_ | 1818300667624685568 |
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| author | Alexander S. Somwaru Stephen Metting Laura M. Flisnik Michael G. Nellamattathil Arjun Sharma Venkat S. Katabathina |
| author_facet | Alexander S. Somwaru Stephen Metting Laura M. Flisnik Michael G. Nellamattathil Arjun Sharma Venkat S. Katabathina |
| author_sort | Alexander S. Somwaru |
| collection | DOAJ |
| description | Abstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments. |
| first_indexed | 2024-12-13T05:10:46Z |
| format | Article |
| id | doaj.art-6a7d87151380435dbe7ba11eea63d161 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-12-13T05:10:46Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-6a7d87151380435dbe7ba11eea63d1612022-12-21T23:58:32ZengBMCBMC Urology1471-24902020-10-012011910.1186/s12894-020-00726-yProstate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasiaAlexander S. Somwaru0Stephen Metting1Laura M. Flisnik2Michael G. Nellamattathil3Arjun Sharma4Venkat S. Katabathina5Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine At Mount SinaiValley Radiology Medical AssociatesDepartment of Radiology, New York Presbyterian/Weill Cornell Medical CenterDepartment of Radiology, MedStar Georgetown University HospitalDepartment of Interventional Radiology, Brigham and Women’s HospitalDepartment of Radiology, University of Texas Health Science Center San AntonioAbstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.http://link.springer.com/article/10.1186/s12894-020-00726-yGiant prostatic hyperplasia (GPH)Prostatic artery embolization (PAE)Lower urinary tract symptoms (LUTS) |
| spellingShingle | Alexander S. Somwaru Stephen Metting Laura M. Flisnik Michael G. Nellamattathil Arjun Sharma Venkat S. Katabathina Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia BMC Urology Giant prostatic hyperplasia (GPH) Prostatic artery embolization (PAE) Lower urinary tract symptoms (LUTS) |
| title | Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| title_full | Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| title_fullStr | Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| title_full_unstemmed | Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| title_short | Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| title_sort | prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia |
| topic | Giant prostatic hyperplasia (GPH) Prostatic artery embolization (PAE) Lower urinary tract symptoms (LUTS) |
| url | http://link.springer.com/article/10.1186/s12894-020-00726-y |
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