Department of Interventional Radiology, University Hospital Southampton, Southampton, UK.
Department of Urology, University Hospital Southampton, Southampton, UK.
Cardiovasc Intervent Radiol. 2020 Mar;43(3):459-465. doi: 10.1007/s00270-019-02381-9. Epub 2019 Dec 3.
Few studies on prostate artery embolization (PAE) follow patients up after 12 months. We aimed to evaluate the symptomatic efficacy of PAE in our patient cohort at 3 years.
A total of 48 consecutive patients undergoing PAE from June 2012 to August 2014 were included in this retrospective study. All patients underwent formal urodynamics to confirm bladder outflow obstruction prior to PAE. International Prostate Symptom Score (IPSS) was performed at baseline, 3 months, 12 months and 3 years post-PAE.
Mean patient age was 65.6 ± 7.4, prostate volume 99.1 ± 56.6 cm, IPSS 23.5 ± 6.0, quality-of-life score 4.6 ± 0.9, Qmax 8.4 ± 2.8 ml/s, post-void residual volume 185.8 ± 55.6 ml. Technical success (bilateral embolization) was achieved in 43 out of 48 cases (89.6%). 11/39 bilateral PAE patients completing follow-up (2 died, 2 lost to follow-up) underwent surgery, indicating a 71.8% clinical success rate at 3 years. No significant change was demonstrated in IPSS or QOL between 1 and 3 years for patients free from surgical intervention (IPSS 8.3 vs 10.0, p = 0.09 and QOL 1.3 vs 1.5, p = 0.23). 3/11 patients undergoing surgery had a prominent 'ball-valve' median lobe, and 1/11 patients had a high bladder neck elevation contributing to symptoms.
Clinical success post-PAE remains high with few patients opting for surgery or experiencing a worsening of symptoms after 12 months.
很少有研究对前列腺动脉栓塞术（PAE）治疗后的患者进行 12 个月以上的随访。我们旨在评估我们的患者队列在 3 年后进行 PAE 的症状缓解效果。
本回顾性研究共纳入 2012 年 6 月至 2014 年 8 月期间接受 PAE 的 48 例连续患者。所有患者均在 PAE 前进行正式尿动力学检查以确认膀胱流出道梗阻。在 PAE 前、后 3 个月、12 个月和 3 年进行国际前列腺症状评分（IPSS）。
患者平均年龄为 65.6±7.4 岁，前列腺体积为 99.1±56.6cm³，IPSS 评分为 23.5±6.0，生活质量评分为 4.6±0.9，最大尿流率为 8.4±2.8ml/s，剩余尿量为 185.8±55.6ml。48 例患者中有 43 例（89.6%）实现了双侧栓塞的技术成功。39 例双侧 PAE 患者中完成随访的 11 例（2 例死亡，2 例失访）接受了手术，3 年时临床成功率为 71.8%。对于未接受手术干预的患者，IPSS 或 QOL 在 1 年至 3 年之间没有显著变化（IPSS 8.3 对 10.0，p=0.09 和 QOL 1.3 对 1.5，p=0.23）。11 例接受手术的患者中有 3 例存在明显的“球瓣”中叶，1 例存在高位膀胱颈抬高导致症状。
PAE 后临床成功率仍然较高，少数患者选择手术或在 12 个月后出现症状恶化。
