Abstract
Objectives:
To assess the safety, short-term efficacy and early functional results of prostate artery embolisation (PAE), an emerging minimally-invasive treatment for symptomatic benign prostate hyperplasia (BPH)
Patients and Methods:
51 men with benign prostate hyperplasia (prostate size >40 cc) causing moderate to severe lower urinary tract symptoms who had either failed or ceased medical therapy, and had declined or where were considered unsuitable for surgical intervention, were recruited to this study. All men underwent baseline clinical assessment, prostate artery embolisation and follow-up to three months post-procedure. The primary endpoints of this study were safety and feasibility. Safety was measured by the incidence of post-procedure adverse events and feasibility was defined by technical success. Secondary endpoints were changes in International Prostate Symptom Score (IPSS) and quality of life (QoL) score at 3 months post PAE.
Results:
No serious adverse events were observed in this study and all procedures were technically successful. For non-catheterised patients, improvement in IPSS and QoL was reported in 95.1% of cases (p<0.0001). The mean reductions in IPSS and QoL were 18.8 points (80.7%) (p<0.0001), and 3.8 points (80.6%) (p<0.0001), respectively. Of the 30 non-IDC dependent men on medical therapy, 23 men were able to completely cease all medications, with all but one of the remaining men reporting significant improvements in IPSS and QOL scores.
Conclusion:
Prostate artery embolisation is a technically feasible and safe procedure, with excellent short-term efficacy. High rates of patient satisfaction were achieved in this study along with significant reductions in prostate symptoms and improvements in QoL. PAE may be an alternative to long term use of medical therapy for symptoms due to BPH.