A PILOT STUDY OF PROSTATIC ARTERIAL EMBOLIZATION FOR TREATMENT OF BENIGN PROSTATIC OBSTRUCTION
1Wessam M. Abdelatif, 2Amr S. El-Dakhakhny and 3Ashraf Enite
1Department of Diagnostic & Interventional Radiology, National Hepatology & Tropical Medicine, Cairo, Egypt
2Department of Urology, Faculty of Medicine, Benha University, Egypt 3Department of Radiology, Faculty of Medicine, El Azhar University, Egypt
Objectives: To test the technical feasibility and clinical utility of prostatic artery embolization (PAE) in high risk patients with benign prostatic obstruction (BPO). Patients and methods: Twenty-six patients with LUTS due to BPH were subjected to PAE between June 2014 and March 2016, in a prospective study. All patients underwent assessment of IPSS, QoL, Qmax, PVR urine volume, prostate volume, serum PSA, pre-procedure and multiple measurements at 1, 3, 6, and 12 months after PAE. Results: The procedure was technically successful in 24/26 patients (92.3%) and failed in two (7.7%). Bilateral PAE in 20(76.9%) cases and in 4(15.4%) unilateral PAE were accomplished. At last follow-up visit, a decrease by 23.5% in PV and 28.5% in PSA level. The IPSS decreased by 17.9 points, the QoL score decreased by 2.3 points. The Qmax increased by 63.1%. Clinical improvement was better after bilateral PAE than unilateral procedure. Complications were recorded in 3(11%); AUR in 2(8%) and hemospermia in 1(4%). Post embolization syndrome occurred in three (11%). All remaining patients were improved at the time of last follow-up, stopped all prostatic medication. Conclusion: PAE is an effective treatment in patients with LUTS due to BPH who are at high risk or not candidates for surgery. The Procedure seems to be effective regardless of prostate size and is associated with early convalescence and short hospital stay. However, the advantages of PAE must be weighed against the risk of technical and clinical failures.