Pouchot Jules, Crombé Amandine, Burlet Luc, Farah Fadi, Baseilhac Pierre, David Arthur, Petitpierre François, Maaloum Rim, Le Bras Yann, Pagnoux Gaele, Derbel Haytham, Kobeiter Hicham, Barral Matthias, Frandon Julien, Marcelin Clément, Klein Clément, Jambon Eva
Service de Radiologie et Imagerie Médicale de L'adulte, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux, France.
SARCOTARGET Team, Bordeaux Institute of Oncology (BRIC) INSERM U1312, 33076 Bordeaux, France.
Diagnostics (Basel). 2024 Dec 19;14(24):2864. doi: 10.3390/diagnostics14242864.
: This multicentric study aimed to evaluate the efficacy and safety of prostatic artery embolization (PAE) to remove indwelling urinary catheter (IUC) in patients with symptomatic benign prostatic hyperplasia (BPH). Secondary objectives were to identify features associated with post-PAE catheter-free survival (PCFS). : All consecutive patients who underwent PAE for IUC related to BPH with a follow-up of at least 2 years (except for early death) in 6 French University Hospitals were retrospectively included. Clinical efficacy was defined as the removal of the IUC after PAE (through a trial without catheter [TWOC]) and evaluated at regular intervals. Chi-square tests, Wilcoxon tests and multivariable binary logistic regressions were utilized to investigate predictors of TWOC success. Univariable and multivariable Cox regressions were utilized to investigate predictors of PCFS in patients with TWOC success. : 140 men with IUC (median age: 82.5 years, interquartile range [IQR] = 73-88.2 years, range: 46-100) who underwent PAE between January 2017 and March 2021 were included. Initial successful catheter removal (TWOC success) following PAE occurred in 113/140 (80.7%) patients, and 3/140 (2.1%) patients encountered major complications. In patients with TWOC success, PCFS at 6 months, 1 year and 2 years were 87.5% (95%CI: 81.4-94.1), 84.4% (95%CI: 77.7-91.7) and 79% (71.3-87.4), respectively. No independent predictive factors for TWOC success and PCFS were identified. : PAE should be considered as a safe option with good clinical efficacy in the short and long term for elderly and inoperable patients with IUC due to symptomatic BPH.
本多中心研究旨在评估前列腺动脉栓塞术（PAE）在有症状的良性前列腺增生（BPH）患者中拔除留置导尿管（IUC）的有效性和安全性。次要目标是确定与PAE后无导尿管生存期（PCFS）相关的特征。
对6家法国大学医院中所有因BPH相关IUC接受PAE且随访至少2年（早期死亡除外）的连续患者进行回顾性纳入。临床疗效定义为PAE后拔除IUC（通过无导尿管试验[TWOC]），并定期进行评估。采用卡方检验、威尔科克森检验和多变量二元逻辑回归来研究TWOC成功的预测因素。采用单变量和多变量Cox回归来研究TWOC成功患者PCFS的预测因素。
纳入了2017年1月至2021年3月期间接受PAE治疗的140例IUC男性患者（中位年龄：82.5岁，四分位间距[IQR]=73 - 88.2岁，范围：46 - 100岁）。PAE后最初成功拔除导尿管（TWOC成功）的患者为113/140（80.7%），3/140（2.1%）的患者出现了严重并发症。在TWOC成功的患者中，6个月、1年和2年的PCFS分别为87.5%（95%CI：81.4 - 94.1）、84.4%（95%CI：77.7 - 91.7）和79%（71.3 - 87.4）。未发现TWOC成功和PCFS的独立预测因素。
对于因有症状的BPH导致IUC的老年和无法手术的患者，PAE应被视为一种短期和长期临床疗效良好的安全选择。
