title: Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population.
abstract: BACKGROUND
  Currently, large prostate size (>80 mL) of benign prostatic hyperplasia (BPH) still pose technical challenges for surgical treatment. This prospective study was designed to explore the safety and efficacy of prostatic arterial embolization (PAE) as an alternative treatment for patients with lower urinary tract symptoms (LUTS) due to largeBPH.
  
  
  METHODS
  A total of 117 patients with prostates >80 mL were included in the study; all were failure of medical treatment and unsuited for surgery. PAE was performed using combination of 50-μm and 100-μm particles in size, under local anaesthesia by a unilateral femoral approach. Clinical follow-up was performed using the international prostate symptoms score (IPSS), quality of life (QoL), peak urinary flow (Qmax), post-void residual volume (PVR), international index of erectile function short form (IIEF-5), prostatic specific antigen (PSA) and prostatic volume (PV) measured by magnetic resonance (MR) imaging, at 1, 3, 6 and every 6 months thereafter.
  
  
  RESULTS
  The prostatic artery origins in this study population were different from previously published results. PAE was technically successful in 109 of 117 patients (93.2%). Follow-up data were available for the 105 patients with a mean follow-up of 24 months. The clinical improvements in IPSS, QoL, Qmax, PVR, and PV at 1, 3, 6, 12, and 24 months was 94.3%, 94.3%, 93.3%, 92.6%, and 91.7%, respectively. The mean IPSS (pre-PAE vs post-PAE 26.0 vs 9.0; P < .0.01), the mean QoL (5.0 vs 3.0; P < 0.01), the mean Qmax (8.5 vs 14.5; P < 0.01), the mean PVR (125.0 vs 40.0; P < 0.01), and PV (118.0 vs 69.0, with a mean reduction of 41.5%; P < 0.01 ) at 24-month after PAE were significantly different with respect to baseline. The mean IIEF-5 was not statistically different from baseline. No major complications were noted.
  
  
  CONCLUSIONS
  PAE is a safe and effective treatment method for patients with LUTS due to large volume BPH. PAE may play an important role in patients in whom medical therapy has failed, who are not candidates for open surgery or TURP or refuse any surgical treatment.
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. wangmq@vip.sina.com.
authors.forename: Mao Qiang
authors.initials: MQ
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. guoliping7521@126.com.
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Guo
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. guodongbear@sina.com.
authors.forename: Guo Dong
authors.initials: GD
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. yuankai80601@126.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Yuan
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. 301likai@sina.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. duanfeng@vip.sina.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Duan
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. mczlks@sina.com.
authors.forename: Jie Yu
authors.initials: JY
authors.lastname: Yan
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. wang_yan_301@163.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. xhkhy@163.com.
authors.forename: Hai Yan
authors.initials: HY
authors.lastname: Kang
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital Beijing, 100853, Beijing, People's Republic of China. 13811023876@163.com.
authors.forename: Zhi Jun
authors.initials: ZJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D011788:Quality of Life; D018570:Risk Assessment; D016896:Treatment Outcome