Prostate Embolization Is Effective Therapy Alternative in Men with Enlarged Prostate and LUTS, Study Finds

Prostate Embolization Is Effective Therapy Alternative in Men with Enlarged Prostate and LUTS, Study Finds

Researchers from the Universidade Nova de Lisboa in Portugal have investigated the efficacy of prostate artery embolization (PAE) as a therapy for patients with benign prostatic hyperplasia (BPH), finding it can successfully provide sustained control of moderate to severe lower urinary tract symptoms (LUTS) in BPH patients with a prostate volume greater than 100 cm3.

The research paper, “Prostate Embolization as an Alternative to Open Surgery in Patients with Large Prostate and Moderate to Severe Lower Urinary Tract Symptoms,” was published in the Journal of Vascular and Interventional.

There are numerous treatment options to treat BPH and BPH-related LUTS. First-line treatment usually consists of medical therapy. In men with moderate to severe LUTS refractory or unresponsive to medical therapy, treatment options usually consist of minimally invasive therapy or surgery, such as transurethral resection of the prostate and prostatectomy, recommended for men with prostate volumes (PV) less than 80-100 cm3 or greater than 80-100 cm3, respectively.

Prostate artery embolization (PAE), a minimally invasive procedure, consists of blocking the blood flow of the artery supplying the prostate through tiny particles inserted through a catheter. These technique results in prostate shrinkage, alleviating some symptoms such as constant urination. PAE has been shown safe and efficient to treat LUTS caused by BPH, with positive short- and medium-term results in patients with PV greater than 80 cm3.

Researchers investigated the efficacy of PAE in patients with PV greater than 100 cm3 and moderate to severe LUTS refractory to medical therapy for at least six months or who had severe urinary retention. Data was assessed from 152 eligible patients who had undergone PAE between March 2009 and September 2014. A successful treatment was defined as improved symptoms, as measured by an International Prostate Symptom Score (IPSS) of 15 or less, improved quality of life, and no need for additional treatments.

Of the 152 men, PAE proved successful in 149  (98 percent), with symptomatic control achieved for a median of 18 months. Researchers also determined 33 clinical failures, 23 in the short-term and 10 in the medium-term.

Despite some trial limitations, the team showed that “the use of PAE is safe and produces good short-term, medium-term, and long-term symptomatic relief in selected patients with BPH, PV greater than 100 cm3, and moderate to severe LUTS or AUR.

“The main advantages of PAE are that the procedure is minimally invasive and can be performed in an outpatient setting. Moreover, it is associated with low morbidity rates, preservation of sexual function, and elimination of daily BPH medications,” the authors wrote.

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