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Prostate Artery Embolization for Lower Urinary Tract Symptoms in Men Unfit for Surgery

1
Department of Diagnostic Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
2
Department of Urology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(2), 46; https://doi.org/10.3390/diagnostics9020046
Received: 21 March 2019 / Revised: 18 April 2019 / Accepted: 24 April 2019 / Published: 25 April 2019
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Abstract

Nearly one in three men develop lower urinary tract symptoms (LUTS) and 10% clinically progress despite medication. Transurethral resection of the prostate (TURP) is the reference standard for symptoms refractory to medical treatment. However, some patients cannot tolerate TURP for medical (e.g., comorbidity) or technical (e.g., large prostate) reasons. This study estimated the safety and effect of prostate artery embolization (PAE) in men unfit for surgery. A prospective, single-centre trial including men with LUTS or urinary retention secondary to benign prostatic hyperplasia (BPH) who were unfit for surgery. The primary objective was to treat urinary retention and LUTS. Outcome measures included International Prostate Symptom Score (IPSS), quality of life (IPSS-QoL), International Index of Erectile Function (IIEF-5), prostate volume (PV), prostate-specific antigen (PSA), peak void flow (Qmax), post-void residual (PVR), and complications. A p-value < 0.05 was considered statistically significant. Eleven consecutive patients with a mean age of 75.2 (SD ± 8.2) underwent PAE. Catheter removal was successful in 60%. IPSS-QoL improved 4.5 points (95% CI: −5.6; −3.4), and PV was reduced by 26.2 cm3 (95% CI: −50.9; −2.3). None of the remaining outcomes changed. No major complications occurred. PAE was effective and safe for LUTS and urinary retention associated with BPH in men unfit for surgery. View Full-Text
Keywords: embolization; therapeutic; prostatic hyperplasia; lower urinary tract symptoms; urinary retention; clinical trial; radiology; interventional embolization; therapeutic; prostatic hyperplasia; lower urinary tract symptoms; urinary retention; clinical trial; radiology; interventional
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Malling, B.; Lönn, L.; Jensen, R.J.; Lindh, M.; Frevert, S.; Brasso, K.; Røder, M.A. Prostate Artery Embolization for Lower Urinary Tract Symptoms in Men Unfit for Surgery. Diagnostics 2019, 9, 46.

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