title: Prostatic Arterial Embolization vs Open Prostatectomy: A 1-Year Matched-pair Analysis of Functional Outcomes and Morbidities.
abstract: OBJECTIVE
  To evaluate 1-year surgical and functional results and morbidities of prostatic artery embolization (PAE) vs open prostatectomy (OP).
  
  
  METHODS
  We undertook 1:1 matched-pair analysis (International Prostate Symptom Score [IPSS], peak flow [PF], postvoid residual [PVR], and prostate volume) of 287 consecutive patients treated for benign prostatic obstruction, including 80 OP and 80 PAE. Inclusion criteria were as follows: lower urinary tract symptoms or benign prostatic obstruction, IPSS ≥12, prostate-specific antigen (PSA) <4 ng/mL, or PSA between 4 and 10 ng/mL but negative prostate biopsy, total prostate volume >80 cm(3), and PF <15 mL/s. Follow-up was performed at 1 month, 6 months, and 1 year at clinic. Primary end points of the study were the comparison regarding IPSS, International Index of Erectile Function-5, PF, PVR, and IPSS quality of life (IPSS-QoL) after 1 year of follow-up.
  
  
  RESULTS
  Regarding primary end points, OP group had lower IPSS (4.31 vs 10.40; P <.05), 1-year PVR (6.15 vs 18.38; P <.05), 1-year PSA (1.33 vs 2.12; P <.05), IPSS-QoL (0.73 vs 2.78; P <.05), International Index of Erectile Function-5 (10.88 vs 15.13; P <.05), and greater PF (23.82 vs 16.89; P <.01). The matched-pair comparison showed higher value of postoperative hemoglobin level (mg/dL) and shorter hospitalization (days) and catheterization (days) for PAE group. At the multivariate logistic regression, PAE was associated with persistent symptoms (IPSS ≥8; odds ratio, 2.67; 95% confidence interval [CI], 0.96-7.4; P <.01) and persistent PF ≤15 mL/s (odds ratio, 4.95; 95% confidence interval, 1.73-14.15; P <.05) after 1 year.
  
  
  CONCLUSIONS
  PAE could be considered a feasible minimally invasive technique but failed to demonstrate superiority to OP because of the increased risk of persistent symptoms and low PF after 1 year.
authors.affiliation: Department of Urology, University of Catania, Catania, Italy. Electronic address: giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Andrological and Urological Department, Endocrinological Research Centre, Moscow, Russia.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Kurbatov
authors.affiliation: Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sansalone
authors.affiliation: Andrological and Urological Department, Endocrinological Research Centre, Moscow, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lepetukhin
authors.affiliation: Andrological and Urological Department, Endocrinological Research Centre, Moscow, Russia.
authors.forename: Sergey
authors.initials: S
authors.lastname: Dubsky
authors.affiliation: Andrological and Urological Department, Endocrinological Research Centre, Moscow, Russia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Sitkin
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Costanza
authors.initials: C
authors.lastname: Salamone
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Fiorino
authors.affiliation: Andrological and Urological Department, Endocrinological Research Centre, Moscow, Russia.
authors.forename: Roman
authors.initials: R
authors.lastname: Rozhivanov
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000368:Aged; D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000628:therapy*; D008297:Male; D016555:Matched-Pair Analysis; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome