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Comparative Study Using 100–300 Versus 300–500 μm Microspheres for Symptomatic Patients Due to Enlarged-BPH Prostates

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Abstract

Purpose

The purpose of the study was to compare safety and efficacy outcomes following prostate artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 100–300 versus 300–500 μm tris-acryl gelatin microspheres.

Materials and Methods

Patients were prospectively treated between August 2011 and June 2013 to receive PAE with 100–300 μm (group A) or 300–500 μm (group B) tris-acryl gelatin microspheres. Patients were followed for a minimum of 12 months and were assessed for changes in International Prostate Symptom Score (IPSS), quality of life (QoL) index, prostate volume determined by magnetic resonance imaging, serum prostate specific antigen (PSA), and maximum urine flow rate (Qmax), as well as any treatment-related adverse events.

Results

Fifteen patients were included in each group, and PAE was technically successful in all cases. Both groups experienced significant improvement in mean IPSS, QoL, prostate volume, PSA, and Qmax (p < 0.05 for all). The differences observed between the two groups included a marginally insignificant more adverse events (p = 0.066) and greater mean serum PSA reduction at 3 months of follow-up (p = 0.056) in group A.

Conclusions

Both 100–300 and 300–500 μm microspheres are safe and effective embolic agents for PAE to treat LUTS-related to BPH. Although functional and imaging outcomes did not differ significantly following use of the two embolic sizes, the greater incidence of adverse events with 100–300 μm microspheres suggests that 300–500 μm embolic materials may be more appropriate.

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Abbreviations

BPH:

Benign prostatic hyperplasia

BOO:

Bladder outlet obstruction

IPSS:

International Prostate Symptom Score

LUTS:

Lower urinary tract symptoms

MRI:

Magnetic resonance imaging

Qmax :

Maximum urinary flow rate

PVA:

Polyvinyl alcohol

PSA:

Prostate-specific antigen

PAE:

Prostatic artery embolization

QoL:

Quality of life index

TURP:

Transurethral resection of the prostate

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Acknowledgments

The authors thank Sardis Honoria Harward for her important collaboration.

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Authors and Affiliations

  1. Interventional Radiology Unit, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil

    Octavio Meneghelli Gonçalves, Francisco Cesar Carnevale, Airton Mota Moreira & Vanessa Cristina Rodrigues

  2. Division of Urology, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil

    Alberto Azoubel Antunes & Miguel Srougi

Authors
  1. Octavio Meneghelli Gonçalves
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  2. Francisco Cesar Carnevale
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  3. Airton Mota Moreira
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  4. Alberto Azoubel Antunes
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  5. Vanessa Cristina Rodrigues
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  6. Miguel Srougi
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Corresponding author

Correspondence to Octavio Meneghelli Gonçalves.

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The authors declare that they have no financial disclosure.

Ethical Approval

All procedures performed in this study were in accordance with the Ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gonçalves, O.M., Carnevale, F.C., Moreira, A.M. et al. Comparative Study Using 100–300 Versus 300–500 μm Microspheres for Symptomatic Patients Due to Enlarged-BPH Prostates. Cardiovasc Intervent Radiol 39, 1372–1378 (2016). https://doi.org/10.1007/s00270-016-1443-x

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  • DOI: https://doi.org/10.1007/s00270-016-1443-x

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