Prostatic artery embolization for the treatment of symptomatic benign prostatic hyperplasia in men ≥75 years: a prospective single-center study

Abstract

Purpose: To compare the safety and efficacy of PAE for the treatment of benign prostatic hyperplasia (BPH) in men ≥75 years, who we defined as elderly, to those <75 years.

Methods: A total of 157 patients diagnosed with lower urinary tract symptoms (LUTS) due to BPH underwent PAE. Group A (n = 52) included patients ≥75 years, and group B (n = 105) included patients <75 years. Follow-up was performed using the International Prostate Symptoms Score (IPSS), quality of life (QoL), peak urinary flow rate (Q max), post-void residual volume (PVR), the International Index of Erectile Function short form (IIEF-5), prostatic-specific antigen (PSA), and prostate volume (PV), at 1, 3, 6, and every 6 months thereafter.

Results: More coexistent systemic diseases were identified in group A than in group B (P < 0.05). Technical success rate of PAE was 90.4 % in group A and 95.2 % in group B (P = 0.06). A total of 147 patients had completed the follow-up with a mean of 20 months. Compared with the baseline, there were significant improvements in IPSS, QoL, Q max, PV, PVR, and PSA in both groups after PAE. There were no significant differences in the changes of IPSS, Q max, PVR, PSA, and IIEF-5 between groups after PAE. No major complications were noted.

Conclusion: PAE could be used as an effective, safe, and well tolerable method in the treatment of elderly symptomatic BPH patients, similarly to younger patients, and it may play an important role in patients in whom medical therapy has failed, who are at high surgical and anesthetic risk or who refuse the standard surgical therapy.

Keywords: Aging disease; Angiography; Benign prostatic hyperplasia (BPH); Lower urinary tract symptoms (LUTS); Prostatic artery embolization (PAE).