Medium- and Long-Term Outcome of Prostate Artery Embolization for Patients with Benign Prostatic Hyperplasia: Results in 630 Patients.
OBJECTIVE
To confirm that prostatic artery embolization (PAE) has a positive medium- and long-term effect in symptomatic benign prostatic hyperplasia (BPH).


METHODS
Between March 2009 and October 2014, 630 consecutive patients with BPH and moderate-to-severe lower urinary tract symptoms refractory to medical therapy for at least 6 months or who refused any medical therapy underwent PAE. Outcome parameters were evaluated at baseline; 1, 3, and 6 months; every 6 months between 1 and 3 years; and yearly thereafter up to 6.5 years.


RESULTS
Mean patient age was 65.1 years ± 8.0 (range, 40-89 y). There were 12 (1.9%) technical failures. Bilateral PAE was performed in 572 (92.6%) patients and unilateral PAE was performed in 46 (7.4%) patients. The cumulative clinical success rates at medium- and long-term follow-up were 81.9% (95% confidence interval [CI], 78.3%-84.9%) and 76.3% (95% CI, 68.6%-82.4%). There was a statistically significant (P < .0001) change from baseline to last observed value in all clinical parameters: International Prostate Symptom Score (IPSS), quality-of-life (QOL), prostate volume, prostate-specific antigen, urinary maximal flow rate, postvoid residual, and International Index of Erectile Function. There were 2 major complications without sequelae.


CONCLUSIONS
PAE had a positive effect on IPSS, QOL, and all objective outcomes in symptomatic BPH. The medium- (1-3 y) and long-term (> 3-6.5 y) clinical success rates were 81.9% and 76.3%, with no urinary incontinence or sexual dysfunction reported.
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal.
João M
JM
Pisco
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Department of Radiology, Nova Medical School, Lisbon, Portugal.
Tiago
T
Bilhim
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Department of Urology, Nova Medical School, Lisbon, Portugal.
Luis C
LC
Pinheiro
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Department of Radiology, Nova Medical School, Lisbon, Portugal.
Lucia
L
Fernandes
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Department of Radiology, Nova Medical School, Lisbon, Portugal.
Jose
J
Pereira
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Department of Radiology, Nova Medical School, Lisbon, Portugal. Electronic address: nunovpcosta@gmail.com.
Nuno V
NV
Costa
Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal.
Marisa
M
Duarte
Department of Pharmacy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
António G
AG
Oliveira
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000000981:diagnostic imaging; D001938:Brazil; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007610:Kallikreins / Q000097:blood; D053208:Kaplan-Meier Estimate; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics
C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen