title: Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case-Control Study.
abstract: OBJECTIVE
  To investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).
  
  
  METHODS
  Twelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from the IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.
  
  
  RESULTS
  The mean age of patients was 68 (61-76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30-55) in the AdBPH group, compared to a mean volume reduction of 22% (9-44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3-15) vs. non-AdBPH median IPSS 13 (8-18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.
  
  
  CONCLUSIONS
  This is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. m.little@doctors.org.uk.
authors.forename: M W
authors.initials: MW
authors.lastname: Little
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: P
authors.initials: P
authors.lastname: Boardman
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Macdonald
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: N
authors.initials: N
authors.lastname: Taylor
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: R
authors.initials: R
authors.lastname: Macpherson
authors.affiliation: Department of Urology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: J
authors.initials: J
authors.lastname: Crew
authors.affiliation: Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. crtapping@doctors.org.uk.
authors.forename: C R
authors.initials: CR
authors.lastname: Tapping
mesh_terms: D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Benign prostatic hyperplasia (BPH); Clinical study; Magnetic resonance imaging (MRI); Prostate artery embolisation (PAE)