[First experience with prostate artery embolization for benign prostatic hyperplasia]

Abstract

This study aimed to evaluate the feasibility of the prostate artery embolization (PAE) in the management of patients with benign prostatic hyperplasia (BPH) in different age groups, depending on the severity of voiding dysfunction, findings of the prostate ultrasound, and the ASA surgical risk.

Materials and methods: The study comprised 39 patients with grade II-III BPH. Patients were divided into three groups, depending on the prostate volume and the grade of anesthesia risk. Patients of the group 1 (n=12), group 2 (n=19), and group 3 (n=8) underwent a classical transvesical prostatic adenomectomy (TPA), bipolar transurethral resection (TUR) of the prostate, and PAE, respectively. The treatment outcomes were assessed at 3 and 6 months after the operation.

Results: When comparing the outcomes in three groups, a statistically significant difference in the IPSS was found both at 3 and 6 months when comparing TPA and TUR groups (p<0.0001) and PAE and TPA groups (p=0.0003). At 3 and 6 months after surgery, postvoid residual urine volume in the TPA and TUR group did not differ statistically significantly, but in the PAE group, it was significantly higher at 6 months than in the other two groups (p=0.004).

Conclusion: As a minimally invasive procedure, prostate artery embolization can become an alternative to TUR and one-stage TPA for patients with verified BPH and grade III ASA risk. This treatment modality can be performed in patients of any age and any prostate volume. The age of the patient does not significantly affect the outcomes of TPA, TUR, and PAE. To recommend this treatment modality as a method of choice, further multi-center, randomized trials are warranted involving longer study duration and larger patient groups.

Keywords: adenomectomy; prostate artery embolization; prostate hyperplasia; transurethral resection of the prostate.