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La radiologia medica

, Volume 120, Issue 4, pp 361–368 | Cite as

Prostatic artery embolization in benign prostatic hyperplasia: preliminary results in 13 patients

  • Maurizio GrossoEmail author
  • Alberto Balderi
  • Matteo Arnò
  • Davide Sortino
  • Alberto Antonietti
  • Fulvio Pedrazzini
  • Grazia Giovinazzo
  • Claudia Vinay
  • Orazio Maugeri
  • Carlo Ambruosi
  • Giuseppe Arena
VASCULAR AND INTERVENTIONAL RADIOLOGY

Abstract

Aim

The aim of the paper is to report the clinical outcome after prostatic artery embolisation (PAE) in 13 consecutive patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).

Materials and methods

From May 2012 to October 2013, we performed PAE in 13 consecutive patients (mean age 75.9 years) with BPH and LUTS and refractory to medical therapy; seven patients had an indwelling bladder catheter. Clinical follow-up (mean follow-up time 244 days) was performed using the international prostate symptoms score (IPSS), quality of life (QoL), the international index of erectile function (IIEF), blood prostatic specific antigen (PSA) testing and transrectal prostatic ultrasound (US) scan with volume and weight calculation at 3, 6 and 12 months. Pre-procedural CT angiography (CTA) was done for vascular mapping. Embolisation was performed using Embosphere (300–500 micron). Technical success was defined when selective prostatic arterial embolisation was completed in at least one pelvic side. Clinical success was defined when symptoms and quality of life were improved.

Results

PAE was technically successful in 12/13 patients (92 %). In one patient, PAE was not performed because of tortuosity and atherosclerosis of iliac arteries. PAE was completed bilaterally in 9/13 (75 %) patients and unilaterally in three (27 %). All patients removed the bladder catheter from 4 days to 4 weeks after PAE. We obtained a reduction in IPSS (mean, 17.1 points), an increase in IIEF (mean, 2.6 points), an improvement in Qol (mean, 2.6 points) and a volume reduction (mean, 28 %) at 12 months.

Conclusions

Consistent with the literature, our experience showed the feasibility, safety and efficacy of PAE in the management of patients with LUTS related to BPH. PAE may play an important role in patients in whom medical therapy has failed, who are not candidates for surgery or transurethral prostatic resection (TURP) or refuse any surgical treatment. Larger case series and comparative studies with standard TURP can confirm the validity of the technique.

Keywords

Prostatic arterial embolization Benign prostatic hyperplasia Lower urinary tract symptoms 

Notes

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Italian Society of Medical Radiology 2014

Authors and Affiliations

  • Maurizio Grosso
    • 1
    Email author
  • Alberto Balderi
    • 1
  • Matteo Arnò
    • 1
  • Davide Sortino
    • 1
  • Alberto Antonietti
    • 1
  • Fulvio Pedrazzini
    • 1
  • Grazia Giovinazzo
    • 1
  • Claudia Vinay
    • 1
  • Orazio Maugeri
    • 2
  • Carlo Ambruosi
    • 2
  • Giuseppe Arena
    • 2
  1. 1.Radiology DepartmentSanta Croce e Carle HospitalCuneoItaly
  2. 2.Urology DepartmentSanta Croce e Carle HospitalCuneoItaly

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