title: Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization.
abstract: BACKGROUND
  Prostate artery embolization (PAE) is a new approach to improve lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia. PAE results in global reduction of prostate volume (PV). There are no data available on the efficacy of PAE in reducing intra-vesical prostatic protrusion (IPP), an anatomic feature that is clinically related with bladder outlet obstruction and LUTS.
  
  
  OBJECTIVE
  To assess the results of PAE in patients with significant IPP due to median lobe hyperplasia and to compare the IPSS decrease and IPP change.
  
  
  METHODS
  Prospective analysis of 18 consecutive patients with significant IPP (>5 mm) related to median lobe hyperplasia undergoing PAE using 30-500-μm-calibrated trisacryl microspheres. We measured IPP on sagittal T2-weighted images before and 3 months after PAE. IPSS and clinical results were also evaluated at 3 months.
  
  
  RESULTS
  PAE resulted in significant IPP reduction (1.57 cm ± 0.55 before PAE and 1.30 cm ± 0.46 after PAE, p = 0.0005) (Fig. 1) with no complication. IPSS, quality of life (QoL), total prostate-specific antigen (PSA) level, and PV showed significant reduction after PAE, and maximum urinary flow rate (Q max) showed significant increase after PAE. No significant change of International Index of Erectile Function (IIEF) for clinical evaluation after PAE. A significant correlation was found between the IPP change and the IPSS change (r = 0.636, p = 0.0045).
  
  
  CONCLUSIONS
  Patients had significant IPP reduction as well as significant symptomatic improvement after PAE, and these improvements were positively correlated.
authors.affiliation: Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France. ymerically@gmail.com.|Department of Radiology, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard Sect. 4, Taichung City, Taiwan, ROC. ymerically@gmail.com.
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Amouyal
authors.affiliation: Urology, Assistance Publique Hopitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Thiounn
authors.affiliation: Sorbonne Paris-Cité, Université Paris Descartes, Paris, France.|Inserm (Institut national de la santé et de la recherche médicale), U970, 56 rue Leblanc, 75015, Paris, France.|Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Pellerin
authors.affiliation: Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Héléna
authors.initials: H
authors.lastname: Pereira
authors.affiliation: Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Costantino
authors.initials: C
authors.lastname: Del Giudice
authors.affiliation: Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Déan
authors.affiliation: Sorbonne Paris-Cité, Université Paris Descartes, Paris, France.|Inserm (Institut national de la santé et de la recherche médicale), U970, 56 rue Leblanc, 75015, Paris, France.|Vascular and Oncological Interventional Radiology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Sapoval
mesh_terms: D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Benign prostate hyperplasia; Intra-vesical prostatic protrusion; Prostate artery embolization (PAE)