title: Prostate Embolization as an Alternative to Open Surgery in Patients with Large Prostate and Moderate to Severe Lower Urinary Tract Symptoms.
abstract: OBJECTIVE
  To evaluate efficacy of prostate artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH), prostate volume (PV) > 100 cm(3).
  
  
  METHODS
  This was a single-center retrospective cohort study. Between March 2009 and September 2014, PAE was performed in patients with a diagnosis of BPH, PV > 100 cm(3), and moderate to severe lower urinary tract symptoms (LUTS) refractory to medical treatment for at least 6 months or who had acute urinary retention. Success was defined as improved symptoms (International Prostate Symptom Score ≤ 15 and decrease of ≥ 25% from baseline score), improved quality of life (measured as score of ≤ 3 points or decrease of ≥ 1 point from baseline), and no need for additional treatment.
  
  
  RESULTS
  PAE was performed in 152 patients 48-87 years old (mean ± SD 67.4 y ± 7.5) with mean PV of 134.2 cm(3) ± 41.8 (range, 101-383 cm(3)). PAE was technically successful in 149 patients (98.0%). Symptomatic control was achieved for a median of 18 months ± 15.5 (range, 3-66 mo). There were 33 clinical failures (23.6%); 23 occurred in the short-term (≤ 6 mo), and 10 occurred in the medium-term (6-24 mo); there were no long-term failures (> 36 mo). Cumulative clinical success rates were 90%, 87.9%, 83.5%, 81.1%, and 77.8% at 1, 3, 6, 12, and 18 months and 72.4% thereafter to 66 months (5.5 y).
  
  
  CONCLUSIONS
  PAE provides sustained short-, medium-, and long-term control for LUTS in patients with BPH and PV > 100 cm(3).
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal. Electronic address: martinspisco@hslouis.pt.
authors.forename: João
authors.initials: J
authors.lastname: Pisco
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Radiology Department, Medicine Faculty, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.affiliation: Urology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal.
authors.forename: Luis C
authors.initials: LC
authors.lastname: Pinheiro
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Radiology Department, Medicine Faculty, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Lúcia
authors.initials: L
authors.lastname: Fernandes
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Radiology Department, Medicine Faculty, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Pereira
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Radiology Department, Medicine Faculty, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Nuno V
authors.initials: NV
authors.lastname: Costa
authors.affiliation: Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal.
authors.forename: Marisa
authors.initials: M
authors.lastname: Duarte
authors.affiliation: Biostatistics Department and Department of Pharmacy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil.
authors.forename: António G
authors.initials: AG
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome