title: Prostatic arterial embolization for benign prostatic hyperplasia: short- and intermediate-term results.
abstract: OBJECTIVE
  To evaluate the safety, morbidity, and short- and intermediate-term results of prostatic arterial embolization (PAE) for benign prostatic hyperplasia (BPH) after failure of medical treatment.
  
  
  METHODS
  This prospective study was approved by the institutional review board, and informed consent was obtained from all participants. Men older than 50 years with a diagnosis of BPH and moderate-to-severe lower urinary tract symptoms that were refractory to medical treatment for 6 months were eligible. PAE with nonspherical 80-180-μm (mean, 100-μm) and 180-300-μm (mean, 200-μm) polyvinyl alcohol particles was performed by means of a single femoral approach in most cases. Effectiveness variables of International Prostate Symptom Score (IPSS), quality of life (QOL) score, peak urinary flow, postvoid residual volume, International Index Erectile Function (IIEF) score, prostate volume, and prostate-specific antigen level were assessed for up to 24 months after the procedure. Statistical analysis included the Kaplan-Meier method and random-effects generalized least squares regression with autoregressive disturbance.
  
  
  RESULTS
  Eighty-nine consecutive patients (mean age, 74.1 years) were included. PAE was technically successful in 86 of the 89 patients (97%). Cumulative rates of clinical improvement in these patients were 78% in the 54 patients evaluated at 6 months and 76% in the 29 patients evaluated at 12 months. At 1-month follow-up, IPSS decreased by 10 points, QOL score decreased by 2 points, peak urinary flow increased by 38%, prostate volume decreased by 20%, postvoid residual volume decreased by 30 mL, and IIEF score increased by 0.5 point (all differences were significant at P < .01). These changes were sustained throughout the observation period. There was one major complication: Intraluminal necrotic tissue attached to the bladder, which was removed with simple surgery and did not necessitate wall reconstruction.
  
  
  CONCLUSIONS
  PAE is a safe and effective procedure, with low morbidity, no sexual dysfunction, and good short- and intermediate-term symptomatic control associated with prostate volume reduction.
authors.affiliation: Department of Interventional Radiology, Hospital São Luís, Rua Luz Soriano 182, 1200-249 Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Pisco
authors.forename: Luís
authors.initials: L
authors.lastname: Campos Pinheiro
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.forename: Marisa
authors.initials: M
authors.lastname: Duarte
authors.forename: Hugo
authors.initials: H
authors.lastname: Rio Tinto
authors.forename: Lúcia
authors.initials: L
authors.lastname: Fernandes
authors.forename: Vítor
authors.initials: V
authors.lastname: Vaz Santos
authors.forename: António Gouveia
authors.initials: AG
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D011142:Polyvinyl Alcohol; D017430:Prostate-Specific Antigen