Prostatic artery embolization in treating benign prostatic hyperplasia: a systematic review
- 636 Downloads
We systemically reviewed the current evidence on prostatic artery embolization (PAE) in treating men with benign prostatic hyperplasia.
A systemic literature search was conducted in PubMed, EMBASE and Web of Science on 1 May 2016 without time constraints. Outcomes of interest included the changes in the International Prostate Symptom Score (IPSS), quality-of-life (QOL) score, peak urinary flow (Qmax), post-void residual urine (PVR), International Index of Erectile Function (IIEF) score, prostate volume (PV) and prostate-specific antigen (PSA) level.
A total of 987 records were identified through database searching. After removing duplicates, screening and reviewing full-length texts, a total of five records remained, with two randomized controlled trials and three non-randomized cohort studies. Transurethral resection of prostate resulted in better IPSS than PAE. Open prostatectomy had better IPSS, QOL score, Qmax and PVR, but worse IIEF score than PAE at 1 year. Unilateral PAE had higher rate of poor clinical outcome than bilateral PAE, but the difference became statistically insignificant after adjusting for age; IPSS, QOL score, Qmax, PVR, IIEF score, PV and PSA did not differ between the two groups. PAE with 100 μm PVA particles resulted in greater reduction in PSA level, but worse IIEF score than PAE with 200 μm PVA particles; IPSS, QOL score, Qmax, PVR, PV and poor clinical outcome did not differ between the two groups.
Evidence on different aspects of PAE was limited. Further studies are warranted to investigate the role of PAE as compared to other forms of medical and surgical treatment.
KeywordsEmbolisation Embolization Prostate Prostatic disease
JYT, PKC and CFN carried out the study. JYT, CHY and HMW participated in the study design. JYT and PKC collected the data. JYT coordinated the study. JYT, PKC and CFN drafted the manuscript. CKC, ESC, SSH and CFN supervised the study.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
Human and animal rights
This article does not contain any studies with human participants performed by any of the authors.
- 5.Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M (2016) Transurethral resection of the prostate (TURP) versus original and PErFecTED prostate artery embolization (PAE) due to benign prostatic hyperplasia (BPH): preliminary results of a single center, prospective, urodynamic-controlled analysis. Cardiovasc Intervent Radiol 39:44–52CrossRefPubMedGoogle Scholar
- 8.Bilhim T, Pisco J, Campos Pinheiro L, Rio Tinto H, Fernandes L, Pereira JA et al (2013) Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol 24(1595–602):e1Google Scholar
- 13.Roehrborn CG, Siami P, Barkin J, Damiao R, Major-Walker K, Nandy I et al (2010) The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol 57:123–131CrossRefPubMedGoogle Scholar
- 16.Serretta V, Morgia G, Fondacaro L, Curto G, Lo Bianco A, Pirritano D et al (1990) Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology 2002(60):623–627Google Scholar