title: Prostatic arterial embolization to treat benign prostatic hyperplasia.
abstract: OBJECTIVE
  To evaluate whether prostatic arterial embolization (PAE) might be a feasible procedure to treat lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Fifteen patients (age range, 62-82 years; mean age, 74.1 y) with symptomatic BPH after failure of medical treatment were selected for PAE with nonspherical 200-μm polyvinyl alcohol particles. The procedure was performed by a single femoral approach. Technical success was considered when selective prostatic arterial catheterization and embolization was achieved on at least one pelvic side.
  
  
  RESULTS
  PAE was technically successful in 14 of the 15 patients (93.3%). There was a mean follow-up of 7.9 months (range, 3-12 months). International Prostate Symptom Score decreased a mean of 6.5 points (P = .005), quality of life improved 1.14 points (P = .065), International Index of Erectile Function increased 1.7 points (P = .063), and peak urinary flow increased 3.85 mL/sec (P = .015). There was a mean prostate-specific antigen reduction of 2.27 ng/mL (P = .072) and a mean prostate volume decrease of 26.5 mL (P = .0001) by ultrasound and 28.9 mL (P = .008) by magnetic resonance imaging. There was one major complication (a 1.5-cm(2) ischemic area of the bladder wall) and four clinical failures (28.6%).
  
  
  CONCLUSIONS
  In this small group of patients, PAE was a feasible procedure, with preliminary results and short-term follow-up suggesting good symptom control without sexual dysfunction in suitable candidates, associated with a reduction in prostate volume.
authors.affiliation: Department of Radiology, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal. joao.pisco@chln.min-saude.pt
authors.forename: João M
authors.initials: JM
authors.lastname: Pisco
authors.forename: Luis C
authors.initials: LC
authors.lastname: Pinheiro
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.forename: Marisa
authors.initials: M
authors.lastname: Duarte
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Mendes
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D001706:Biopsy; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005240:Feasibility Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010410:Penile Erection; D010865:Pilot Projects; D011142:Polyvinyl Alcohol / Q000008:administration & dosage* / Q000009:adverse effects; D011174:Portugal; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000098:blood supply; D014563:Urodynamics
chemical_list: D011142:Polyvinyl Alcohol; D017430:Prostate-Specific Antigen