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Prostatic Artery Embolization: A Promising Technique in the Treatment of High-Risk Patients with Benign Prostatic Hyperplasia

2016; Karger Publishers; Volume: 97; Issue: 3 Linguagem: Inglês

10.1159/000447360

1423-0399

Ahmed H. Gabr, Mohamed F. Gabr, Basheer N. Elmohamady, Abul‐fotouh Ahmed,

Urologic and reproductive health conditions

<b><i>Introduction:</i></b> Prostatic artery embolization (PAE) has recently started to be viewed as a promising technology that could be an alternative to different treatment options of benign prostatic hyperplasia (BPH), especially in high-risk patients. The aim of our study was to evaluate the efficacy and safety of PAE in BPH patients who are at high risk for surgery and/or anesthesia. <b><i>Materials and Methods:</i></b> Between June 2013 and February 2015, BPH patients >50 years with lower urinary tract symptoms (LUTS) refractory to BPH-related medical therapy or had an indwelling urethral catheter due to refractory urine retention were prospectively enrolled in the study. All patients were at high risk for surgery and/or anesthesia. The PAE was performed and the embolising material used was biosphere 300-500 µm particles. Pre- and 1, 3, 9 months post-intervention, all patients were assessed by detailed medical history, physical examination, serum prostate-specific antigen (PSA), uroflowmetry, and abdominal and transrectal ultrasonography. <b><i>Results:</i></b> Twenty-two consecutive patients with a mean age of 72.50 years and a mean prostate volume of 77.30 ± 14.89 cm³ were included. The PAE procedure was successful in all patients. Throughout the period of follow-up, there was a significant improvement in the LUTS and urinary flow rate, and reduction in prostate volume and serum PSA (for all p < 0.001). No major complications were reported. <b><i>Conclusion:</i></b> Our results show that BPH patients with failed medical treatment who are at high risk for surgery and/or anesthesia could be treated safely and effectively through PAE.