title: Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates.
abstract: OBJECTIVE
  To compare the outcomes of prostatic arterial embolization (PAE) in treating large (>80 mL) in comparison with medium-sized prostate glands (50-80 mL) to determine whether size affects the outcome of PAE.
  
  
  METHODS
  A total of 115 patients (mean age 71.5 years) diagnosed with lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) refractory to medical treatment underwent PAE. Group A (n = 64) included patients with a mean prostate volume of 129 mL; group B (n = 51) included patients with a mean prostate volume of 64 mL. PAE was performed using 100-μm particles. Follow-up was performed using the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Qmax ), post-void residual urine volume (PVR), the International Index of Erectile Function short form (IIEF-5), prostate-specific antigen (PSA) and prostate volume measured by magnetic resonance imaging at 1, 3 and 6 months, and every 6 months thereafter.
  
  
  RESULTS
  There were no significant differences between groups in baseline IPSS, QoL, Qmax , PVR, PSA level or IIEF-5 score. The technical success rate was 93.8% in group A and 96.8% in group B (P = 0.7). A total of 101 patients (55 patients in group A and 46 patients in group B) completed the mean (range) follow-up of 17 (12-33) months. Compared with baseline, there were significant improvements in IPSS, QoL, Qmax , prostate volume and PVR in both groups after PAE. The outcomes in group A were significantly better than in group B with regard to mean ± sd IPSS (-14 ± 6.5 vs -10.5 ± 5.5, respectively), Qmax (6.0 ± 1.5 vs 4.5 ± 1.0 mL/s, respectively), PVR (-80.0 ± 25.0 vs -60.0 ± 20.0 mL, respectively), prostate volume (-54.5 ± 18.0 mL [-42.3%] vs -18.5 ± 5.0 mL [-28.9%], respectively), and QoL score (-3.0 ± 1.5 vs -2.0 ± 1.0) with P values <0.05. The mean IIEF-5 score was not significantly different from baseline in both groups. No major complications were noted.
  
  
  CONCLUSIONS
  We found that PAE is a safe and effective treatment method for patients with LUTS attributable to BPH. The clinical and imaging outcomes of PAE were better in patients with larger prostate glands than medium-sized ones.
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Maoqiang
authors: M
authors: Wang
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Liping
authors: L
authors: Guo
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Feng
authors: F
authors: Duan
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Kai
authors: K
authors: Yuan
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Guodong
authors: G
authors: Zhang
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Kai
authors: K
authors: Li
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Jieyu
authors: J
authors: Yan
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China.
authors: Haiyan
authors: H
authors: Kang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000453:epidemiology
keywords: BPH; LUTS; angiography; prostatic arterial embolization