Prostate Artery Embolization Should Focus on BPH Patients with Adenomas, Study Says

Prostate Artery Embolization Should Focus on BPH Patients with Adenomas, Study Says

Men with benign prostatic hyperplasia (BPH) who have multiple adenomas in their prostate gland respond better to treatment with prostate artery embolization that other BPH patients, a recent study suggests.

Based on the findings, researchers suggest that screening for the presence of adenomas may assist in BPH patient selection for the procedure and improve its success rate.

The study, “Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case-Control Study,” appeared in the journal CardioVascular and Interventional Radiology.

Prostate adenomas are a type of non-cancerous tumors present in many men with BPH. Since the nodules have a dense network of blood vessels, researchers at Britain’s Churchill Hospital reasoned that a BPH treatment that targets blood flow might be particularly helpful for such patients.

Researchers identified 12 people with adenomatous-dominant BPH among a group of men participating in the ongoing STREAM trial, which is evaluating the effects of prostate artery embolization on BPH. The study defined the condition as having two or more adenomas of 1 cm diameter or larger within the central gland. To identify the adenomas, scientists scanned all patients with a specific type of magnetic resonance imaging.

As controls, researchers selected 12 BPH patients of the same age who did not fulfill the requirements for adenomatous-dominant BPH.

The groups did not differ in their International Prostate Symptom Score (IPSS), erectile function or quality of life, before the intervention.

Doctors successfully performed the prostate artery embolization procedure on 23 of the 24 participants. One patient in the control group did not get the procedure, however, since physicians could not identify his prostate arteries. With the exception of two patients in the adenoma group, all received the embolization procedure on both sides of the prostate.

Before the procedure, researchers noted that men with adenomas had significantly larger prostates. The procedure shrank the prostate’s volume by 36 percent in these patients, and by 25 percent in those without adenomas. IPSS scores and quality of life measurements also improved more in the adenoma group, while neither group had any changes in sexual function.

Based on the data, researchers believe that focusing on patients with adenomas will maximize the procedure’s success rate.

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