title: Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study.
abstract: OBJECTIVE
  This study was designed to describe the clinical, laboratorial, and urodynamic findings of prostatic artery embolization (PAE) in patients with urinary retention due to benign prostatic hyperplasia (BPH).
  
  
  METHODS
  A prospective study of 11 patients with urinary retention due to BPH was conducted. Patients underwent physical examination, prostate specific antigen (PSA) measurement, transrectal ultrasound, and magnetic resonance imaging. International prostate symptom score (IPSS), quality of life (QoL), and urodynamic testing were used to assess the outcome before and after 1 year.
  
  
  RESULTS
  Clinical success was 91% (10/11 patients) with a mean follow-up of 22.3 months (range, 12-41 months). At the first year follow-up, the mean IPSS score was 2.8 points (p = 0.04), mean QoL was 0.4 points (p = 0.001), mean PSA decreased from 10.1 to 4.3 ng/mL (p = 0.003), maximum urinary flow (Qmax) improved from 4.2 to 10.8 mL/sec (p = 0.009), and detrusor pressure (Pdet) decreased from 85.7 to 51.5 cm H2O (p = 0.007). Before PAE, Bladder Outlet Obstruction Index (BOOI) showed values >40 in 100% of patients. After PAE, 30% of patients were >40 (obstructed), 40% were between 20 and 40 (undetermined), and 30% were <20 (unobstructed). Patients with a BOOI <20 had higher PSA values at 1-day after PAE.
  
  
  CONCLUSIONS
  Clinical and urodynamic parameters improved significantly after PAE in patients with acute urinary retention due to BPH. Total PSA at day 1 after PAE was higher in patients with unobstructed values in pressure flow studies.
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-001, Brazil.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Carnevale
authors.forename: Joaquim M
authors.initials: JM
authors.lastname: da Motta Leal Filho
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Yoshinaga
authors.forename: Luciana M O
authors.initials: LM
authors.lastname: Cerri
authors.forename: Ronaldo H
authors.initials: RH
authors.lastname: Baroni
authors.forename: Antonio S Z
authors.initials: AS
authors.lastname: Marcelino
authors.forename: Giovanni G
authors.initials: GG
authors.lastname: Cerri
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000368:Aged; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D019160:Endosonography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014563:Urodynamics
chemical_list: D017430:Prostate-Specific Antigen