Iossa Vincenzo, Punzi Ernesto, Pandolfo Savio Domenico, Spena Gianluca, Russo Pierluigi, Giulioni Carlo, Aveta Achille, Spirito Lorenzo, Lombardi Giulio, Imperatore Vittorio
Department of Urology, Azienda Ospedaliera "S.G. Moscati", 83100 Avellino, Italy.
Department of Radiology, Azienda Ospedaliera "S.G. Moscati", 83100 Avellino, Italy.
J Clin Med. 2025 May 28;14(11):3775. doi: 10.3390/jcm14113775.
Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), particularly in high-risk surgical candidates. This study aims to evaluate the efficacy, safety, and clinical outcomes of PAE, combining a retrospective case series with a narrative review of the literature. : A single-center retrospective analysis was conducted on 10 patients aged ≥ 70 years with moderate-to-severe LUTS due to BPH who underwent PAE between January 2021 and January 2024. Inclusion criteria included IPSS > 18, Qmax < 12 mL/s, prostate volume > 45 cc, and resistance to medical therapy. Embolization was performed using 300-500 µm tris-acryl gelatin microspheres via the PErFecTED technique. Follow-up included IPSS, Qmax, prostate volume (PV), PSA levels, and complications. A narrative review of 18 studies ( = 1539 patients) was also conducted to contextualize findings. : Technical success was achieved in all patients (100%), and clinical success (IPSS reduction ≥ 50%) in 90%. At 12 months, the following significant improvements were observed: mean IPSS decreased from 24 to 12 ( < 0.0001), Qmax increased from 8.7 to 12.6 mL/s ( < 0.0001), PV reduced from 66.4 to 49.4 cc ( < 0.0001), and PSA from 5.0 to 3.4 ng/mL ( < 0.0001). Outcomes remained stable up to 36 months. Two patients developed transient post-procedural fever; no major complications were recorded. : PAE is a safe and effective treatment for LUTS related to BPH, offering durable symptom relief and minimal morbidity, particularly in elderly and comorbid patients. While the evidence supports its role as an alternative to TURP, larger prospective trials are necessary to confirm its long-term efficacy and optimize patient selection.
前列腺动脉栓塞术（PAE）已成为治疗良性前列腺增生（BPH）继发下尿路症状（LUTS）的一种微创替代方法，尤其是对于高风险手术候选患者。本研究旨在结合回顾性病例系列和文献叙述性综述，评估PAE的疗效、安全性和临床结果。：对2021年1月至2024年1月期间接受PAE治疗的10例年龄≥70岁、因BPH导致中重度LUTS的患者进行了单中心回顾性分析。纳入标准包括国际前列腺症状评分（IPSS）>18、最大尿流率（Qmax）<12 mL/s、前列腺体积>45 cc以及对药物治疗耐药。通过PErFecTED技术使用300 - 500 µm的三丙烯酸明胶微球进行栓塞。随访包括IPSS、Qmax、前列腺体积（PV）、前列腺特异性抗原（PSA）水平和并发症。还对18项研究（n = 1539例患者）进行了叙述性综述，以将研究结果置于背景中。：所有患者均取得技术成功（100%），90%取得临床成功（IPSS降低≥50%）。在12个月时，观察到以下显著改善：平均IPSS从24降至12（P<0.0001），Qmax从8.7增至12.6 mL/s（P<0.0001），PV从66.4降至49.4 cc（P<0.0001），PSA从5.0降至3.4 ng/mL（P<0.0001）。直至36个月时结果保持稳定。2例患者术后出现短暂发热；未记录到重大并发症。：PAE是治疗与BPH相关LUTS的一种安全有效的方法，能提供持久的症状缓解且发病率极低，尤其适用于老年和合并症患者。虽然现有证据支持其作为经尿道前列腺切除术（TURP）替代方法的作用，但需要更大规模的前瞻性试验来证实其长期疗效并优化患者选择。
