Efficacy and safety of prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: a systematic review and meta-analysis

Wang, Xiaoyan; Zong, Huantao; Zhang, Yong

doi:10.2147/cia.s119241

Cited by 41 publications

(27 citation statements)

References 21 publications

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“…None of the reviewed studies showed a decrease in IIEF score after PAE. Three meta-analyses of PAE (51,54,56) showed slight improvement of IIEF score after PAE, whereas 2 meta-analyses (52,55) showed no change. The 3 RCTs of PAE (28)(29)(30) showed no change in IIEF score following PAE.…”

Section: Safety Of Paementioning

confidence: 97%

“…Six meta-analyses of PAE for BPH have been published (51)(52)(53)(54)(55)(56). The largest and most recent (51) was a systematic review of trials studying the efficacy of PAE to treat LUTS, performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with a meta-analysis done using the random-effects model.…”

Section: Meta-analysesmentioning

confidence: 99%

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Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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BPH ¼ benign prostatic hyperplasia, IIEF ¼ International Index of Erectile Function, IPSS ¼ International Prostate Symptom Score, LUTS ¼ lower urinary tract symptoms, MIST ¼ minimally invasive surgical therapies, OP ¼ open prostatectomy, PAE ¼ prostatic artery embolization, PVR ¼ postvoid residual, QOL ¼ quality of life, RCT ¼ randomized controlled trial, TURP ¼ transurethral resection of the prostate, UK-ROPE ¼ United Kingdom Register of Prostate Embolization BACKGROUND Benign prostatic hyperplasia (BPH) describes the proliferation of the glandular and stromal tissue in the transition zone of the prostate, which may result in bladder outlet obstruction and consequent lower urinary tract symptoms (LUTS). The prevalence of BPH increases with age, affecting more than 70% of men older than 70 years (1), and one fourth of men older than 70 years have moderate to severe LUTS that impair their quality of life (QOL) (2,3). Thus, BPH and ensuing LUTS represent a significant health issue affecting millions of men. The International Prostate Symptom Score (IPSS; also known as the American Urologic Association Symptom Index) is a validated instrument that quantifies a patient's subjective urinary symptoms on a 35-point scale (4). The IPSS also incorporates a urinary QOL score, which assesses how the patient feels overall about his urinary symptoms. Nearly all studies assessing BPH treatments for LUTS use the IPSS and QOL scores to assess patients before and after treatment. A 3-point change in IPSS is noticeable by a man with LUTS (5), and a 30% reduction in IPSS is considered clinically acceptable for a treatment to be considered effective (6,7). Medical therapies, including a-1 blockers and 5-a reductase inhibitors, are the mainstay of treatment for mild to moderate LUTS. The symptomatic relief is relatively modest, with IPSS improvement in the range of 3-7 points (8). Although generally considered safe, medical

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Section: Safety Of Paementioning

confidence: 97%

Section: Meta-analysesmentioning

confidence: 99%

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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“…Özellikle çok büyük hacimli prostatı ya da median lob hipertrofisi olan hastalarda işlemden sonra akut üriner retansiyon görülebilir (%7-9).Bu durumda hasta sondalanmalı ve 3-5 gün sonda ile takip edilmelidir. Literatürdeki tüm çalışmalarda işlem sonrası üriner retansiyon geliştiren tüm hastalarda 1. haftada spontan idrar çıkışı gözlemlenmiştir [47][48][49][50].…”

Section: İstenmeyen Etkiler Ve Komplikasyonlarunclassified

“…Hayatı tehdit edici majör komplikasyon şu ana kadar literatürde bildirilmemiştir. Bunun dışında da erektil disfonksiyon ya da retrograd ejakü-lasyon hiçbir seride tanımlanmamıştır [48][49][50][51][52][53].…”

Section: İstenmeyen Etkiler Ve Komplikasyonlarunclassified

Benign Prostat Hiperplazisinde Prostatik Arter Embolizasyonu

Eldem¹,

Fakultesi²,

Peynircioğlu³

2018

Trd Sem

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“…Prostate artery embolization (PAE) is a new minimally invasive procedure [8], non-invasive to the urinary system and possible to perform as day-care treatment.…”

Section: Introductionmentioning

confidence: 99%

Introduction of prostate artery embolization (PAE) in Sweden

Lindgren

Bläckberg

2019

Scandinavian Journal of Urology

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Background: Transurethral resection of the prostate (TURP) is 'Gold Standard' treatment for moderateto-severe lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) with bladderoutlet obstruction (BOO). However, TURP is associated with a risk of complications, so minimally invasive methods have been developed. Prostate artery embolization (PAE) is a new minimally invasive procedure. This study reports the outcomes of PAE when introduced in a 'real life' clinical setting in a Swedish County hospital. Methods: A prospective, single-center, single-arm study in a consecutive vascular-anatomy 'all comers' population, eligible for TURP or adenomaenukleation, but unsuitable for this, treated with PAE from January 2015 to June 2018. Defined improvement of IPSS/QoL scores, or freedom from urinary catheter if previous urinary catheter-dependent, or clean intermittent catheterization (CIC) were considered as clinically successful treatments. PAE was performed until arterial stasis using the Perfected technique. Most patients were treated during a day-care procedure. Results: Of 37 treated men, bilateral PAEs were achieved in 32 patients, unilateral PAEs in four patients, and bilateral failure in one patient due to difficult vascular anatomy. Clinically successful treatment was achieved in 84%, without serious adverse events. Conclusions: PAE was introduced in Sweden, showing PAE as a novel and good minimally invasive alternative in treatment of symptomatic BPH, possible to perform as a day-care procedure.

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Efficacy and safety of prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: a systematic review and meta-analysis

Cited by 41 publications

References 21 publications

Benign Prostat Hiperplazisinde Prostatik Arter Embolizasyonu

Introduction of prostate artery embolization (PAE) in Sweden

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