Lin Fangfang, Chen Qian, Gao Meizhu, Ji Yuanyuan, Ruan Dandan, Zhang Jianhui, Zhou Yanfeng, Wu Shaojie, Cai Senlin, Luo Jiewei, Fang Zhuting, Tang Yi
Department of Radiology and Traditional Chinese Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.
Department of Radiology, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.
Transl Androl Urol. 2024 Sep 30;13(9):1847-1858. doi: 10.21037/tau-24-215. Epub 2024 Sep 26.
In recent years, prostatic artery embolization (PAE) has gradually become a hot topic in the treatment of symptomatic benign prostatic hyperplasia (BPH). However, there is an ongoing debate regarding the best embolization material for PAE. This study aimed to compare the safety and efficacy of the temperature-sensitive liquid embolic agent (TempSLE) combined with polyvinyl alcohol (PVA) microspheres and simple PVA microspheres for PAE in treating lower urinary tract symptoms (LUTS) caused by BPH.
The clinical data of 39 patients with LUTS caused by BPH were included in this study, including 21 cases of PVA microspheres group and 18 cases of PVA microspheres + TempSLE group. The changes in various subjective and objective indexes were compared between the two groups before PAE, 1 and 3 months after operation.
Three months after operation, the improvement in prostate volume (PV), post-void residual volume (PVR), peak urinary flow rate (Q), international prostate symptom score (IPSS), quality of life (QoL) and total prostate-specific antigen (T-PSA) in both groups were significantly improved compared with those before operation (P<0.05). And the above clinical improvement indicators at the 3-month mark demonstrated a statistically significant difference between the two groups (P<0.05). Compared with the PVA microspheres group, the prostate necrosis rate of the PVA microspheres + TempSLE was higher at 1 and 3 months after operation (P<0.05). Moreover, the PVA microspheres + TempSLE group had no significant complications, with the exception of a single case of transient gross hematuria during the perioperative period.
The combination of PVA microspheres and TempSLE for PAE appears to be safe and effective in the treatment of symptomatic BPH patients, with a higher degree of damage to hyperplastic prostate tissue compared to simple PVA microspheres embolization.
近年来，前列腺动脉栓塞术（PAE）已逐渐成为有症状良性前列腺增生（BPH）治疗中的一个热门话题。然而，关于PAE的最佳栓塞材料仍存在争议。本研究旨在比较温度敏感液体栓塞剂（TempSLE）联合聚乙烯醇（PVA）微球与单纯PVA微球用于PAE治疗BPH所致下尿路症状（LUTS）的安全性和有效性。
本研究纳入39例BPH所致LUTS患者的临床资料，其中PVA微球组21例，PVA微球+TempSLE组18例。比较两组在PAE术前、术后1个月和3个月时各项主观和客观指标的变化。
术后3个月，两组患者的前列腺体积（PV）、残余尿量（PVR）、最大尿流率（Q）、国际前列腺症状评分（IPSS）、生活质量（QoL）和总前列腺特异性抗原（T-PSA）较术前均有显著改善（P<0.05）。且两组在术后3个月时上述临床改善指标差异有统计学意义（P<0.05）。与PVA微球组相比，PVA微球+TempSLE组术后1个月和3个月时的前列腺坏死率更高（P<0.05）。此外，PVA微球+TempSLE组除围手术期有1例短暂肉眼血尿外，无明显并发症。
PVA微球与TempSLE联合用于PAE治疗有症状的BPH患者似乎是安全有效的，与单纯PVA微球栓塞相比，对增生前列腺组织的损伤程度更高。
