title: Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement.
abstract: OBJECTIVE
  This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS).
  
  
  METHODS
  This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-μm nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach.
  
  
  RESULTS
  Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04).
  
  
  CONCLUSIONS
  PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.
authors.affiliation: Departamento Universitário de Anatomia, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa (UNL), Campo dos Mártires da Pátria, 130, Lisbon, 1169-056, Portugal. tiagobilhim@hotmail.com
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.forename: João
authors.initials: J
authors.lastname: Pisco
authors.forename: Hugo
authors.initials: H
authors.lastname: Rio Tinto
authors.forename: Lúcia
authors.initials: L
authors.lastname: Fernandes
authors.forename: Luís
authors.initials: L
authors.lastname: Campos Pinheiro
authors.forename: Marisa
authors.initials: M
authors.lastname: Duarte
authors.forename: José A
authors.initials: JA
authors.lastname: Pereira
authors.forename: António G
authors.initials: AG
authors.lastname: Oliveira
authors.forename: João
authors.initials: J
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015901:Angiography, Digital Subtraction; D001158:Arteries; D001706:Biopsy; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005263:Femoral Artery; D006801:Humans; D016015:Logistic Models; D059411:Lower Urinary Tract Symptoms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011467:Prostate / Q000098:blood supply* / Q000000981:diagnostic imaging; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D011142:Polyvinyl Alcohol