title: Occlusion of the Internal Iliac Artery Is Associated with Smaller Prostate and Decreased Urinary Tract Symptoms.
abstract: OBJECTIVE
  To characterize the relationship of proximal internal iliac artery (IIA) occlusion or embolization on prostate volume (PV) and the presence of lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH).
  
  
  METHODS
  The study included 2 parts: Part 1 comprised 99 men ≥ 50 years old who underwent abdominopelvic computed tomography angiography for lower extremity claudication assessed in a retrospective cohort design; Part 2 comprised 18 patients who underwent iatrogenic IIA embolization during endovascular aneurysm repair assessed by a within-subjects approach. Prostate volume and IIA origin diameter were measured; IIA occlusion was noted. Chart review documented body mass index, LUTS, impotence, and buttock claudication.
  
  
  RESULTS
  Of 99 men in Part 1, 60 had no IIA occlusion, and 39 had IIA occlusion (17 unilateral, 22 bilateral). Prostate volume differed significantly between groups (no IIA occlusion, 27.3 mL; unilateral IIA occlusion, 20.7 mL; bilateral IIA occlusion, 17.1 mL; P = .001). Men without IIA occlusion had more LUTS (27%) than men with IIA occlusion (10%; P = .04). The number of men with complaints of impotence or buttock claudication was similar in both groups (40% vs 46%; P > .05). Multiple regression showed that age and IIA occlusion were independent predictors of PV (P < 0.05), whereas body mass index was not (P > .05), and that IIA occlusion was the only independent predictor of LUTS/BPH (P < .05). Among the 18 men in Part 2, PV declined by 29% after embolization (P = .00001); 6 men had improvement or resolution of LUTS.
  
  
  CONCLUSIONS
  Proximal IIA occlusion is associated with nearly one-third reduction in PV and decreased findings of LUTS/BPH.
authors.affiliation: Division of Vascular & Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Deipolyi
authors.affiliation: Division of Vascular & Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.
authors.forename: Shehab
authors.initials: S
authors.lastname: Al-Ansari
authors.affiliation: Biomaterials Innovation Research Center, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts.
authors.forename: Ali
authors.initials: A
authors.lastname: Khademhosseini
authors.affiliation: Division of Vascular & Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114. Electronic address: roklu@mgh.harvard.edu.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Oklu
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007083:Iliac Artery / Q000187:drug effects; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D011467:Prostate / Q000187:drug effects / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics