Introduction& Objectives:
Prostate artery embolisation (PAE) has emerged as a minimally-invasive option in the management of lower urinary tract symptoms (LUTS) from benign prostate hyperplasia (BPH). Previous studies have demonstrated that PAE is safe and effective, but few studies have evaluated PAE outcomes with formal urodynamic studies.
Methods:
97 patients with medically refractive BPH and moderate to severe lower urinary tracts symptoms consented to prostate artery embolization and baseline urodynamic studies. Follow-up urodynamic studies and repeat imaging of the prostate were booked as per protocol at 12 months post-PAE (range 9 – 26 months, with COVID restrictions impacting the timing of follow-up for some patients). Statistical analysis was undertaken using paired t-test or Wilcoxon test as appropriate.
Results:
Statistically significant improvements in maximum urinary flow (p=0.0038), detrusor pressure (p=0.0026) and bladder outlet obstruction index (p=0.0015) were recorded on follow-up urodynamic studies. Prostate volume and symptoms severity score (IPSS) both reduced significantly by 32% and 57% respectively (p<0.0001). Average quality of life score changed from “mostly dissatisfied” to “mostly satisfied” at final follow-up.
Conclusions:
Formal urodynamic studies demonstrate durable improvements in bladder function and reduced outlet obstruction 12 months after PAE. Prostate artery embolisation is a viable option to long term medical therapy to manage obstructive BPH within the context of a collaborative interventional radiology and urology LUTS service.