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Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

  • M. W. LittleEmail author
  • P. Boardman
  • A. C. Macdonald
  • N. Taylor
  • R. Macpherson
  • J. Crew
  • C. R. TappingEmail author
Clinical Investigation

Abstract

Purpose

To investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).

Materials and 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.

Keywords

Prostate artery embolisation (PAE) Magnetic resonance imaging (MRI) Benign prostatic hyperplasia (BPH) Clinical study 

Notes

Acknowledgements

The authors wish to acknowledge the Royal College of Radiologists, UK, and Oxfordshire Health Services Research Committee (OHSRC) (Grant No. 1170) for funding the study.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • M. W. Little
    • 1
    Email author
  • P. Boardman
    • 1
  • A. C. Macdonald
    • 1
  • N. Taylor
    • 1
  • R. Macpherson
    • 1
  • J. Crew
    • 2
  • C. R. Tapping
    • 1
    Email author
  1. 1.Department of Radiology, Churchill HospitalOxford University Hospitals NHS Foundation TrustOxfordUK
  2. 2.Department of Urology, Churchill HospitalOxford University Hospitals NHS Foundation TrustOxfordUK

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