title: Prostatic artery embolization in benign prostatic hyperplasia: preliminary results in 13 patients.
abstract: OBJECTIVE
  The aim of the paper is to report the clinical outcome after prostatic artery embolisation (PAE) in 13 consecutive patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).
  
  
  METHODS
  From May 2012 to October 2013, we performed PAE in 13 consecutive patients (mean age 75.9 years) with BPH and LUTS and refractory to medical therapy; seven patients had an indwelling bladder catheter. Clinical follow-up (mean follow-up time 244 days) was performed using the international prostate symptoms score (IPSS), quality of life (QoL), the international index of erectile function (IIEF), blood prostatic specific antigen (PSA) testing and transrectal prostatic ultrasound (US) scan with volume and weight calculation at 3, 6 and 12 months. Pre-procedural CT angiography (CTA) was done for vascular mapping. Embolisation was performed using Embosphere (300-500 micron). Technical success was defined when selective prostatic arterial embolisation was completed in at least one pelvic side. Clinical success was defined when symptoms and quality of life were improved.
  
  
  RESULTS
  PAE was technically successful in 12/13 patients (92%). In one patient, PAE was not performed because of tortuosity and atherosclerosis of iliac arteries. PAE was completed bilaterally in 9/13 (75%) patients and unilaterally in three (27%). All patients removed the bladder catheter from 4 days to 4 weeks after PAE. We obtained a reduction in IPSS (mean, 17.1 points), an increase in IIEF (mean, 2.6 points), an improvement in Qol (mean, 2.6 points) and a volume reduction (mean, 28%) at 12 months.
  
  
  CONCLUSIONS
  Consistent with the literature, our experience showed the feasibility, safety and efficacy of PAE in the management of patients with LUTS related to BPH. PAE may play an important role in patients in whom medical therapy has failed, who are not candidates for surgery or transurethral prostatic resection (TURP) or refuse any surgical treatment. Larger case series and comparative studies with standard TURP can confirm the validity of the technique.
authors.affiliation: Radiology Department, Santa Croce e Carle Hospital, Via Coppino 26, 12100, Cuneo, Italy, grosso.m@ospedale.cuneo.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Grosso
authors.forename: Alberto
authors.initials: A
authors.lastname: Balderi
authors.forename: Matteo
authors.initials: M
authors.lastname: Arnò
authors.forename: Davide
authors.initials: D
authors.lastname: Sortino
authors.forename: Alberto
authors.initials: A
authors.lastname: Antonietti
authors.forename: Fulvio
authors.initials: F
authors.lastname: Pedrazzini
authors.forename: Grazia
authors.initials: G
authors.lastname: Giovinazzo
authors.forename: Claudia
authors.initials: C
authors.lastname: Vinay
authors.forename: Orazio
authors.initials: O
authors.lastname: Maugeri
authors.forename: Carlo
authors.initials: C
authors.lastname: Ambruosi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Arena
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D059411:Lower Urinary Tract Symptoms; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014563:Urodynamics