Interventional Radiology Department, Radiology Institute, University of São Paulo Medical School Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
Interventional Radiology Department, Radiology Institute, University of São Paulo Medical School Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil; Interventional Radiology Department, Sírio-Libanês Hospital, São Paulo, Brazil.
J Vasc Interv Radiol. 2021 Jan;32(1):106-112. doi: 10.1016/j.jvir.2020.09.023. Epub 2020 Oct 27.
To compare the outcomes of prostatic artery embolization (PAE) in patients with different intravesical prostatic protrusion (IPP) grades.
This retrospective single-center study included 128 patients (aged 50-86 years) who underwent PAE from 2013 to 2017. IPP grades were classified as follows: grade I (<10 mm), grade II (10-19 mm), and grade III (≥20 mm). Nineteen patients (14.8%) had grade I [mean IPP 7.8 mm, prostatic volume (PV) 64.1 cm], 77 (60.2%) had grade II (mean IPP 14.9 mm, PV 87.0 cm), and 32 (25%) had grade III (mean IPP 26.2 mm, PV 132.6 cm), P < .01. The outcomes, including PV, international prostate symptom score (IPSS), and quality of life (QoL), were compared between the IPP grades at the 12-month follow-up. Clinical failure was defined as IPSS >7 or QoL >2.
IPP decreased (I: -8.2%, II: -27.3%, and III: -38.7%, P = .01), and all other endpoints improved (P < .01). Adjusted covariance analysis, considering baseline PV as a confounding factor, showed no correlation between the 12-month outcomes and baseline IPP. Clinical failure was observed in 17/128 patients (13.3%) and was similar in prevalence among the IPP groups (P = .20). Minor complications occurred in 43 patients (33.6%) and major in 3 (2.3%). There were statistical differences in the complications between IPP grades II and III (P < .01).
PAE was similarly effective in all the IPP grades at the 12-month follow-up, and there was no difference in the clinical failure between the groups. Complications in IPP grade III were more frequent than those in IPP grade II.
比较不同膀胱内前列腺突出（IPP）分级患者前列腺动脉栓塞（PAE）的结局。
本回顾性单中心研究纳入了 2013 年至 2017 年期间行 PAE 的 128 例患者（年龄 50-86 岁）。IPP 分级如下：Ⅰ级（<10mm）、Ⅱ级（10-19mm）和Ⅲ级（≥20mm）。19 例（14.8%）为Ⅰ级[平均 IPP 7.8mm，前列腺体积（PV）64.1cm]，77 例（60.2%）为Ⅱ级（平均 IPP 14.9mm，PV 87.0cm），32 例（25%）为Ⅲ级（平均 IPP 26.2mm，PV 132.6cm），P<.01。在 12 个月随访时，比较 IPP 分级之间的 PV、国际前列腺症状评分（IPSS）和生活质量（QoL）等结局。临床失败定义为 IPSS>7 或 QoL>2。
IPP 减少（Ⅰ级：-8.2%，Ⅱ级：-27.3%，Ⅲ级：-38.7%，P=.01），所有其他终点均改善（P<.01）。考虑到基线 PV 为混杂因素的协方差分析显示，12 个月的结局与基线 IPP 之间无相关性。128 例患者中有 17 例（13.3%）发生临床失败，IPP 组间发生率相似（P=.20）。43 例（33.6%）发生轻微并发症，3 例（2.3%）发生严重并发症。Ⅱ级和Ⅲ级 IPP 之间的并发症发生率存在统计学差异（P<.01）。
PAE 在 12 个月随访时对所有 IPP 分级均有效，且各组间临床失败无差异。Ⅲ级 IPP 的并发症发生率高于Ⅱ级 IPP。
