Department of Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands,
Cardiovasc Intervent Radiol. 2014 Oct;37(5):1198-219. doi: 10.1007/s00270-014-0948-4. Epub 2014 Jul 9.
This study was designed to summarize the evidence on clinical outcomes and complications of prostatic arterial embolization (PAE) in patients with benign prostatic hyperplasia (BPH).
We searched Medline and Embase for PAE trials of patients with BPH upto November 2013. Two reviewers independently checked the inclusion and exclusion criteria and performed data extraction of study characteristics, quantitative and qualitative outcomes, and complications.
The search yielded 562 studies, of which 9 articles with 706 patients were included. In these 9 articles, there was a possible overlap of data and the quality of 8 studies was assessed as poor. All patients had moderate-to-severe, lower urinary tract symptoms (LUTS). The mean age ranged from 63.4-74.1 years. After embolization, a decrease of the prostate volume (PV) and post void residual (PVR) was seen mainly in the first month with a further decrease up to 12 months, increasing afterwards. The prostate specific antigen (PSA) decreased up to 3 months after PAE, increasing afterwards. The peak urinary flow (Qmax) increased mainly the first month and decreased after 30 months. The international prostate symptom score (IPSS) and quality of life-related symptoms (QOL) improved mainly during the first month, with a further improvement up to 30 months. No deterioration of the international index of erectile function (IIEF) was seen after PAE. The PAE procedure seems safe.
Although the number of studies was small, qualitatively poor, and with overlap of patients, the initial clinical outcomes as reported up to 12 months seem positive and the procedure seems safe.
本研究旨在总结前列腺动脉栓塞术（PAE）治疗前列腺增生（BPH）患者的临床疗效和并发症的证据。
我们检索了 Medline 和 Embase 中截至 2013 年 11 月的 PAE 治疗 BPH 的试验。两位评审员独立检查了纳入和排除标准，并对研究特征、定量和定性结果以及并发症进行了数据提取。
检索结果显示有 562 项研究，其中 9 项研究共 706 例患者符合纳入标准。这 9 项研究中可能存在数据重叠，其中 8 项研究的质量被评估为较差。所有患者均有中重度下尿路症状（LUTS）。平均年龄为 63.4-74.1 岁。栓塞后，前列腺体积（PV）和残余尿量（PVR）主要在第一个月减少，直到 12 个月后进一步减少，之后增加。前列腺特异性抗原（PSA）在 PAE 后 3 个月内下降，之后增加。最大尿流率（Qmax）主要在第一个月增加，30 个月后减少。国际前列腺症状评分（IPSS）和生活质量相关症状（QOL）主要在第一个月改善，直到 30 个月后进一步改善。PAE 后国际勃起功能指数（IIEF）没有恶化。PAE 过程似乎是安全的。
尽管研究数量较少，质量较差，且患者存在重叠，但报告的 12 个月内的初步临床疗效似乎是积极的，且该过程似乎是安全的。
