Assess long-term outcomes of prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH).
Materials and Methods
Single centre retrospective study from 2009–2019 including 1072 patients who received PAE and had available follow-up. Patients were evaluated yearly at 1–10 years post PAE using the International Prostate Symptom Score (IPSS) and quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax) and postvoid residual (PVR) volume. The need for prostatic medication, re-intervention rates, repeat PAE and prostatectomy rates were assessed with Kaplan–Meier survival analysis and compared between different embolic agents using Cox regression analysis.
Mean follow-up time was 4.39 ± 2.37 years. At last follow-up visit, mean IPSS and QoL improvements were − 10.14 ± 8.34 (p < .0001) and − 1.87 ± 1.48 (p < .0001) points, mean PV reduction was − 6.82 ± 41.11 cm3 (p = 0.7779), mean PSA reduction was − 1.12 ± 4.60 ng/mL (p = 0.9713), mean Qmax increase was 2.72 ± 6.38 mL/s (p = 0.0005), mean PVR reduction was − 8.35 ± 135.75 mL (p = 0.6786). There were 335 patients (31.3%) needing prostatic medication after PAE. Re-intervention rates were 3.4% at 1 year, 21.1% at 5 years and 58.1% at 10 years. Repeat-PAE rates were 2.3% at 1 year, 9.5% at 5 years and 23.1% at 10 years. Prostatectomy rates were 1.1% at 1 year, 11.6% at 5 years and 35.0% at 10 years. No significant differences were found between polyvinyl alcohol particles, Bead Block, Embospheres and Embozenes.
PAE induces durable long-term LUTS relief, with re-intervention rates of 20% in the first 5 years and 30%–60% > 5 years post-PAE.
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Conflict of interest
Tiago Bilhim is a paid consultant for Merit Medical and has received speaker fees for Philips Medical, Cook Medical, Terumo and is a stock holder for EmbolX. Nuno Vasco Costa is a paid consultant for Merit Medical. Tiago Bilhim had control of the study data.
Institutional review board approval was obtained for the retrospective analysis of data.
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Bilhim, T., Costa, N.V., Torres, D. et al. Long-Term Outcome of Prostatic Artery Embolization for Patients with Benign Prostatic Hyperplasia: Single-Centre Retrospective Study in 1072 Patients Over a 10-Year Period. Cardiovasc Intervent Radiol 45, 1324–1336 (2022). https://doi.org/10.1007/s00270-022-03199-8
- Prostatic artery embolization (PAE)
- Benign prostatic hyperplasia (BPH)
- Benign prostatic obstruction (BPO)
- Bladder outlet obstruction (BOO)
- Lower urinary tract symptoms (LUTS)