TY - JOUR
T1 - Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement
AU - O'neill, João Erse de Goyri
AU - Oliveira, António Manuel Gouveia de
AU - Fernandes, Lúcia Fátima da Cunha
AU - Rio Tinto, Hugo Alexandre Meireles
AU - Bilhim, Tiago Campos Andrada de Faria
AU - Pinheiro, Luís Manuel Viegas de Campos
PY - 2013/1/1
Y1 - 2013/1/1
N2 - This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-mu m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 \%) patients (group A). The remaining 19 (15.6 \%) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 \% of patients from group A and 47.4 \% from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 \% improvement in the IPSS score and a prostate volume reduction of 19 \%, with good clinical outcome in up to 75 \% of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 \% of patients after unilateral PAE may have a good clinical outcome.
AB - This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-mu m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 \%) patients (group A). The remaining 19 (15.6 \%) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 \% of patients from group A and 47.4 \% from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 \% improvement in the IPSS score and a prostate volume reduction of 19 \%, with good clinical outcome in up to 75 \% of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 \% of patients after unilateral PAE may have a good clinical outcome.
KW - Lower urinary tract symptoms
KW - HYPERPLASIA
KW - Unilateral
KW - Benign prostatic hyperplasia
KW - HEMATURIA
KW - Prostatic arterial embolization
KW - EXPERIENCE
KW - HEMORRHAGE
U2 - 10.1007/s00270-012-0528-4
DO - 10.1007/s00270-012-0528-4
M3 - Article
C2 - 23232858
SN - 0174-1551
VL - 36
SP - 403
EP - 411
JO - Cardiovascular And Interventional Radiology
JF - Cardiovascular And Interventional Radiology
IS - 2
ER -