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Prostatic Arterial Embolization Treating Moderate-to-Severe Lower Urinary Tract Symptoms Related to Benign Prostate Hyperplasia: A Meta-Analysis

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To evaluate the clinical efficiency and safety of PAE treating moderate-to-severe LUTS related to BPH.

Materials and Methods

A systematic literature search was performed using PUBMED, EMBASE, Cochrane database of systematic review, and Web of Science, up to April 2016, to identify eligible studies. The Cochrane Collaboration’s RevMan 5.3 was used to analyze the extracted data. Random- or fixed-effect model was selected to fit the pooled out heterogeneity.

Results

20 eligible studies were included in this meta-analysis. Synthetic data showed that there were statistically significant improvements in IPSS (MD = −13.25; 95% CI −14.81 to −11.69; P < 0.00001), QoL score (MD = −2.34; 95% CI −2.69 to −2.00, P < 0.00001), PSA level (MD = −1.33; 95% CI −1.86 to −0.80; P < 0.00001), PV (MD = −28.00; 95% CI −35.94 to −20.07; P < 0.00001), Qmax (MD = 5.51; 95% CI 4.62 to 6.40; P < 0.00001), and PVR (MD = −67.8; 95% CI −81.35 to −53.60; P < 0.00001). There was no significant difference in IIEF score (MD = 0.93; 95% CI 0.43–1.42; P = 0.07). Major complications following PAE include pain in the perineum, retropubic area, and/or urethra (9.4%), and hematuria (9.0%).

Conclusions

PAE should be considered to be the very promising alternative treatment for those who do not want or cannot tolerate surgical treatment, with its benefits on IPSS, QoL score, PSA level, PV, Qmax, and PVR without affecting erectile function.

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Abbreviations

PAE:

Prostatic arterial embolization

LUTS:

Lower urinary tract symptoms

IPSS:

International prostate symptom score

QoL:

Quality of life

IIEF:

International index of erectile function

PSA:

Prostate specific antigen

PV:

Prostate volume

Qmax:

Maximum urinary flow rate/peak urinary flow rate

PVR:

Postvoid residual volume

TURP:

Transurethral resection of the prostate

MeSH:

Medical subject headings

SD:

Standard deviation

SE:

Standard error

NOS:

Newcastle–Ottawa quality assessment scale

CI:

Confidence interval

MD:

Mean difference

UTI:

Urinary tract infection

OP:

Open prostatectomy

NA:

Not acquired

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Funding

The research received no specific Grant from any funding agency in public, commercial, or non-profit sectors.

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Authors and Affiliations

  1. Institute of Urology (Laboratory of Reconstructive Urology), Sichuan University, Chengdu, 610041, Sichuan, China

    Shijian Feng, Zirui Li, Hong Li & Kunjie Wang

  2. Department of Urology Surgery, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

    Ye Tian

  3. Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

    Wei Liu

  4. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

    Tuo Deng

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  1. Shijian Feng
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Correspondence to Kunjie Wang.

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Shijian Feng and Ye Tian are Co-first authors.

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Feng, S., Tian, Y., Liu, W. et al. Prostatic Arterial Embolization Treating Moderate-to-Severe Lower Urinary Tract Symptoms Related to Benign Prostate Hyperplasia: A Meta-Analysis. Cardiovasc Intervent Radiol 40, 22–32 (2017). https://doi.org/10.1007/s00270-016-1516-x

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