title: Efficacy and Safety of Prostatic Arterial Embolization: Systematic Review with Meta-Analysis and Meta-Regression.
abstract: This study attempted to overcome the limitations of previous systematic reviews to determine the overall treatment efficacy and safety of prostatic arterial embolization compared with standard therapy.
  
  
  
  Meta-analyses were done of randomized, controlled and single group trials. Meta-regression analysis of the moderator effect was performed with single group analysis. The outcomes measured were mean changes in I-PSS (International Prostate Symptom Score), quality of life, maximal urinary flow rate, prostate volume, post-void residual volume and prostate specific antigen. Adverse events were compared as proportional differences between the embolization group and groups receiving other therapies in comparative studies.
  
  
  
  A total of 16 studies met our selection criteria and were included in the meta-analysis. Three studies were comparative and included a total of 297 subjects, including 149 in the experimental groups and 148 in the control groups. The other 13 studies were noncomparative and included a total of 750 experimental subjects. Pooled overall standardized mean differences for embolization in I-PSS, maximal urinary flow rate and prostate volume were significantly impaired in the experimental vs control groups. Overall weighted mean differences for all outcomes except prostate specific antigen were significantly improved from baseline by embolization treatment in noncomparative studies. Sensitivity analysis of study duration showed that all outcome measurements did not differ before vs after 6 months.
  
  
  
  Although there is growing evidence of the efficacy and safety of prostatic arterial embolization for benign prostatic hyperplasia, this systematic review using meta-analysis and meta-regression showed that prostatic arterial embolization should still be considered an experimental treatment modality.
authors: Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Republic of Korea.
authors: Sung Ryul
authors: SR
authors: Shim
authors: Medical Affairs Department, Astellas Pharma Europe, Middle East and Africa, Chertsey, United Kingdom.
authors: Karan J K
authors: KJ
authors: Kanhai
authors: Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea.
authors: Young Myoung
authors: YM
authors: Ko
authors: Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Republic of Korea. Electronic address: piacekjh@hanmail.net.
authors: Jae Heon
authors: JH
authors: Kim
mesh_terms: D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D006801:Humans; D007610:Kallikreins / Q000097:blood; D059411:Lower Urinary Tract Symptoms / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D017410:Practice Guidelines as Topic; D011467:Prostate / Q000098:blood supply; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: arteries; embolization; investigational; prostatic hyperplasia; therapeutic; therapies; treatment outcome