Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jul;31(7):4929-4946.
doi: 10.1007/s00330-020-07663-2. Epub 2021 Jan 15.

Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials

Peng Xiang  1   2 , Di Guan  1 , Zhen Du  1 , Yongxiu Hao  3 , Wei Yan  1 , Yonghui Wang  1 , Yutong Liu  1 , Dan Liu  1 , Hao Ping  4   5
Affiliations
Meta-Analysis

Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials

Peng Xiang et al. Eur Radiol. 2021 Jul.

Abstract

Objective: To investigate the efficacy and safety of prostatic artery embolization (PAE) vs. transurethral resection of the prostate (TURP) in patients affected by benign prostatic hyperplasia (BPH). We also reviewed mean changes from baseline in PAE at selected follow-up points.

Methods: PubMed, Web of Science, and Embase were searched up to May 1, 2020. Randomized controlled trials on PAE were collected according to specific inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3, STATA 14, and GraphPad Prism 8. Pooled patient-reported scores and functional outcomes were calculated by using a fixed or random-effect model.

Results: Eleven articles met our selection criteria and ten independent patient series were included in the final analysis. Pooled estimates suggested no significant difference between TURP and PAE for patient-reported outcomes including International Prostate Symptom Score (2.32 (- 0.44 to 5.09)) and quality of life (0.18 (- 0.41 to 0.77)) at 12 months. PAE was less effective regarding improvements in most functional outcomes such as maximum flow rate, prostate volume, and prostate-specific antigen. Moreover, PAE may be associated with relatively fewer complications, lower cost, and shorter hospitalization. After the PAE procedure, the overall weighted mean differences for all outcomes except sexual health scores were significantly improved from baseline during follow-up to 24 months.

Conclusion: PAE is non-inferior to TURP with regard to improving patient-reported outcomes, though most functional parameters undergo more changes after TURP than after PAE. Moreover, PAE can significantly continue to relieve symptoms for 24 months without causing serious complications.

Key points: • PAE is as effective as TURP in improving subjective symptom scores, with fewer complications and shorter hospitalization times. • PAE is inferior to TURP in the improvement of most functional outcomes. • Improvements due to PAE are durable during follow-up to 24 months.

Keywords: Benign prostatic hyperplasia; Embolization, therapeutic; Lower urinary tract symptoms; Meta-analysis; Systematic review.

PubMed Disclaimer

References

    1. Roehrborn CG (2005) Benign prostatic hyperplasia: an overview. Rev Urol 7(Suppl 9):S3–S14 - PubMed - PMC
    1. Parsons JK, Dahm P, Kohler TS, Lerner LB, Wilt TJ (2020) Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020. J Urol 204:799–804 - PubMed
    1. Chughtai B, Forde JC, Thomas DD et al (2016) Benign prostatic hyperplasia. Nat Rev Dis Primers 2:16031 - PubMed
    1. Gravas S, Cornu J, Gacci M et al (2020). European Association of Urology. Management of non-neurogenic Male LUTS. Available via: https://uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/#5 . Accessed 1 May, 2020
    1. Xu XF, Liu GX, Zhu C et al (2020) Alpha1-blockers and 5alpha-reductase inhibitors are the most recommended drugs in treating benign prostatic hyperplasia: an evidence-based evaluation of clinical practice guidelines. Front Pharmacol 11:311 - PubMed

LinkOut - more resources