Andrological and Urological Department, Endocrinological Research Center, Moscow, Russia.
Department of Urology, University of Catania, Catania, Italy.
Urology. 2014 Aug;84(2):400-4. doi: 10.1016/j.urology.2014.04.028. Epub 2014 Jun 12.
To investigate clinical benefits and safety of prostatic artery embolization (PAE) in patients with prostate volume ≥80 cm(3) and Charlson comorbidity index (CCI) ≥2 and affected by benign prostatic obstruction (BPO).
From January 2009 to January 2012, PAE was performed in 88 consecutive patients affected by clinical BPO. Inclusion criteria were symptomatic BPO refractory to medical treatment, International Prostate Symptom Score (IPSS) ≥12, total prostate volume (TPV) ≥80 cm(3), Qmax <15 mL/s, and CCI ≥2. Primary end points were the reduction of 7 points of the IPSS and the increase of Qmax. Secondary end points were the reduction of TPV, postvoid residue (PVR), prostate-specific antigen (PSA), International Index of Erectile Function 5 score, and IPSS-quality of life (QoL). Follow-up was addressed at 3 months, 6 months, and at 1 year.
The mean IPSS (10.40 vs 23.98; P <.05) and the mean Qmax (16.89 vs 7.28; P <.05) at 1 year were significantly different with respect to baseline. When considering secondary end points, we observed significant variation in terms of PVR (18.38 vs 75.25; P <.05), TPV (71.20 vs 129.31; P <.05), and PSA level (2.12 vs 3.67; P <.05) at 1 year compared with baseline. Finally, the mean IPSS-QoL significantly changed from baseline to 1 year after PAE (5.10 vs 2.20; P <.05). No minor or major complications were reported.
We showed clinical benefits of PAE for the treatment of lower urinary tract symptoms and/or BPO by reducing IPSS, TPV, PSA, PVR, and improvement in urinary flow and QoL after 1 year in patients with prostate volume ≥80 cm(3) and CCI ≥2.
研究前列腺动脉栓塞术（PAE）在前列腺体积≥80cm³和Charlson 合并症指数（CCI）≥2 且受良性前列腺梗阻（BPO）影响的患者中的临床获益和安全性。
2009 年 1 月至 2012 年 1 月，对 88 例临床 BPO 患者进行了 PAE。纳入标准为药物治疗无效的有症状 BPO、国际前列腺症状评分（IPSS）≥12、总前列腺体积（TPV）≥80cm³、Qmax＜15ml/s 和 CCI≥2。主要终点为 IPSS 降低 7 分和 Qmax 增加。次要终点为 TPV、剩余尿量（PVR）、前列腺特异性抗原（PSA）、国际勃起功能指数 5 评分和 IPSS 生活质量（QoL）的降低。随访时间为 3 个月、6 个月和 1 年。
1 年后，平均 IPSS（10.40 分比 23.98 分；P＜0.05）和平均 Qmax（16.89 分比 7.28 分；P＜0.05）与基线相比有显著差异。考虑到次要终点，我们观察到 PVR（18.38 分比 75.25 分；P＜0.05）、TPV（71.20 分比 129.31 分；P＜0.05）和 PSA 水平（2.12 分比 3.67 分；P＜0.05）在 1 年内与基线相比有显著变化。最后，PAE 后 1 年的平均 IPSS-QoL 与基线相比显著变化（5.10 分比 2.20 分；P＜0.05）。无轻微或严重并发症发生。
我们发现，在前列腺体积≥80cm³和 CCI≥2 的患者中，PAE 治疗 1 年后可降低 IPSS、TPV、PSA、PVR、改善尿流和 QoL，从而改善下尿路症状和/或 BPO 的临床疗效。
