对于患有大前列腺且伴有中度至重度下尿路症状的患者，前列腺栓塞可作为开放手术的替代方案。

Prostate Embolization as an Alternative to Open Surgery in Patients with Large Prostate and Moderate to Severe Lower Urinary Tract Symptoms.

作者信息

Pisco João, Bilhim Tiago, Pinheiro Luis C, Fernandes Lúcia, Pereira José, Costa Nuno V, Duarte Marisa, Oliveira António G

机构信息

Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal.

Interventional Radiology Department, Hospital Saint Louis, R. Luz Soriano, Lisbon 1200-249, Portugal; Radiology Department, Medicine Faculty, Universidade Nova de Lisboa, Lisbon, Portugal.

出版信息

J Vasc Interv Radiol. 2016 May;27(5):700-8. doi: 10.1016/j.jvir.2016.01.138. Epub 2016 Mar 26.

DOI:10.1016/j.jvir.2016.01.138

PMID:27019980

Abstract

PURPOSE

To evaluate efficacy of prostate artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH), prostate volume (PV) > 100 cm(3).

MATERIALS AND METHODS

This was a single-center retrospective cohort study. Between March 2009 and September 2014, PAE was performed in patients with a diagnosis of BPH, PV > 100 cm(3), and moderate to severe lower urinary tract symptoms (LUTS) refractory to medical treatment for at least 6 months or who had acute urinary retention. Success was defined as improved symptoms (International Prostate Symptom Score ≤ 15 and decrease of ≥ 25% from baseline score), improved quality of life (measured as score of ≤ 3 points or decrease of ≥ 1 point from baseline), and no need for additional treatment.

RESULTS

PAE was performed in 152 patients 48-87 years old (mean ± SD 67.4 y ± 7.5) with mean PV of 134.2 cm(3) ± 41.8 (range, 101-383 cm(3)). PAE was technically successful in 149 patients (98.0%). Symptomatic control was achieved for a median of 18 months ± 15.5 (range, 3-66 mo). There were 33 clinical failures (23.6%); 23 occurred in the short-term (≤ 6 mo), and 10 occurred in the medium-term (6-24 mo); there were no long-term failures (> 36 mo). Cumulative clinical success rates were 90%, 87.9%, 83.5%, 81.1%, and 77.8% at 1, 3, 6, 12, and 18 months and 72.4% thereafter to 66 months (5.5 y).

CONCLUSIONS

PAE provides sustained short-, medium-, and long-term control for LUTS in patients with BPH and PV > 100 cm(3).

摘要

目的

评估前列腺动脉栓塞术（PAE）对前列腺体积（PV）>100 cm³的良性前列腺增生（BPH）患者的疗效。

材料与方法

这是一项单中心回顾性队列研究。2009年3月至2014年9月期间，对诊断为BPH、PV>100 cm³且有中度至重度下尿路症状（LUTS）且药物治疗至少6个月无效或有急性尿潴留的患者进行PAE。成功定义为症状改善（国际前列腺症状评分≤15分且较基线评分降低≥25%）、生活质量改善（测量为评分≤3分或较基线降低≥1分）且无需额外治疗。

结果

对152例年龄在48 - 87岁（平均±标准差67.4岁±7.5）的患者进行了PAE，平均PV为134.2 cm³±41.8（范围101 - 383 cm³）。149例患者（98.0%）PAE技术成功。症状控制的中位时间为18个月±15.5（范围3 - 66个月）。有33例临床失败（23.6%）；23例发生在短期（≤️6个月），10例发生在中期（6 - 24个月）；无长期失败（>36个月）。1、3、6、12和18个月时的累积临床成功率分别为90%、87.9%、83.5%、81.1%和77.8%，此后至66个月（5.5年）为72.4%。