Patel Neeral R, Elterman Dean S, Thulasidasan Narayanan, Altman Rachel, Tai Elizabeth, Zener Rebecca, Stella Steffan F, Annamalai Ganesan, Mafeld Sebastian, Simons Martin E
Division of Interventional Radiology, 7989University Health Network, Toronto, Ontario, Canada.
Department of Urology, 7989University Health Network, Toronto, Ontario, Canada.
Can Assoc Radiol J. 2021 Nov;72(4):876-882. doi: 10.1177/0846537120939930. Epub 2020 Jul 16.
This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH).
A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure. Prostate imaging was performed preprocedure as well as 3 months and 12 months post-procedure to assess prostate volume (PV). Uroflowmetry was also performed at baseline and 12 months post-procedure to assess urine flow rate (Q) and post-void residual (PVR) volume. Adverse events were graded according to Society of Interventional Radiology (SIR) guidelines.
Eighty male patients underwent the PAE procedure (mean age 69 years). Prostate volume decreased significantly from a mean volume 156 to 107 mL after 12 months post-procedure, commensurate with a mean reduction of 27.5% ( < .05). Significant improvements were seen in IPSS (21.8 vs 10.5) and QoL (4.5 vs 2.0) from baseline to 12 months post-procedure ( < .05). There was no significant change in IIEF-5 score. There was a significant reduction in PVR (202 vs 105 mL) and improvement in Q (5.9 vs 10.0 mL/s) between baseline and 12 months post-procedure ( < .05). No major complications occurred; 4 minor complications occurred (SIR grade A or B).
Prostate artery embolization achieved a clinically and statistically significant prostate volume reduction, symptom and QoL improvement, and enhanced uroflowmetry parameters in patients with BPH.
本研究旨在评估前列腺动脉栓塞术(PAE)治疗良性前列腺增生(BPH)的中期疗效和安全性。
对因BPH接受PAE治疗的患者进行单中心回顾性研究。在基线期及术后至少12个月时,完成经过验证的国际前列腺症状评分(IPSS)、生活质量(QoL)指数和国际勃起功能指数(IIEF-5)问卷。在术前以及术后3个月和12个月进行前列腺成像,以评估前列腺体积(PV)。在基线期和术后12个月也进行尿流率测定,以评估尿流率(Q)和残余尿量(PVR)。不良事件根据介入放射学会(SIR)指南进行分级。
80例男性患者接受了PAE手术(平均年龄69岁)。术后12个月时,前列腺体积从平均156 mL显著降至107 mL,平均减少27.5%(P <.05)。从基线期到术后12个月,IPSS(21.8 vs 10.5)和QoL(4.5 vs 2.0)有显著改善(P <.05)。IIEF-5评分无显著变化。基线期和术后12个月之间,PVR显著降低(202 vs 105 mL),Q显著改善(5.9 vs 10.0 mL/s)(P <.05)。未发生重大并发症;发生4例轻微并发症(SIR A级或B级)。
前列腺动脉栓塞术使BPH患者的前列腺体积在临床和统计学上显著减小,症状和生活质量得到改善,尿流率参数得到提高。