title: Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia.
abstract: OBJECTIVE
  To perform meta-analysis of available data on prostatic artery embolization (PAE).
  
  
  METHODS
  Meta-analysis was conducted on articles published between November 2009 and December 2015. Peer-reviewed studies with > 5 patients and standard deviations and/or individual-level data on one or more of the following outcomes were included: prostate volume (PV), peak flow rate (Qmax), postvoid residual (PVR), International Prostate Symptom Score (IPSS), quality of life (QOL) score, International Index of Erectile Function (IIEF) score, and prostate-specific antigen (PSA) level. A random-effects meta-analysis was performed on the outcomes at 1, 3, 6, and 12 months after PAE compared with baseline values, with a P < .05 decision rule as the null hypothesis rejection criterion.
  
  
  RESULTS
  Nineteen of 268 studies were included in data collection, with 6 included in the meta-analysis. At 12 months, PV decreased by 31.31 cm3(P < .001), PSA remained unchanged (P = .248), PVR decreased by 85.54 mL (P < .001), Qmax increased by 5.39 mL/s (P < .001), IPSS improved by 20.39 points (P < .001), QOL score improved by -2.49 points (P < .001), and IIEF was unchanged (P = 1.0). There were a total of 218 adverse events (AEs) among 662 patients (32.93%), with 216 being Society of Interventional Radiology class A/B (99%). The most common complications were rectalgia/dysuria (n = 60; 9.0%) and acute urinary retention (n = 52; 7.8%). No class D/E complications were reported.
  
  
  CONCLUSIONS
  PAE provided improvement in Qmax, PVR, IPSS, and QOL endpoints at 12 months, with a low incidence of serious AEs (0.3%), although minor AEs were common (32.93%). There was no adverse effect on erectile function.
authors.affiliation: Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Andre
authors.initials: A
authors.lastname: Uflacker
authors.affiliation: Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia, 1215 Lee St., Charlottesville, VA 22908. Electronic address: haskaljvir@gmail.com.
authors.forename: Ziv J
authors.initials: ZJ
authors.lastname: Haskal
authors.affiliation: Interventional Radiology Department, Saint Louis Hospital, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.affiliation: Department of Public Health Sciences, University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: James
authors.initials: J
authors.lastname: Patrie
authors.affiliation: Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Timothy
authors.initials: T
authors.lastname: Huber
authors.affiliation: Interventional Radiology Department, Saint Louis Hospital, Lisbon, Portugal.
authors.forename: João Martins
authors.initials: JM
authors.lastname: Pisco
mesh_terms: D001158:Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen