Prostate embolization: patient selection, clinical management and results

Young, Shamar; Golzarian, Jafar

doi:10.1186/s42155-019-0049-1

Cited by 14 publications

(14 citation statements)

References 45 publications

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“…However, there is a lack of evidence regarding their medium to long-term outcomes. 12–15 Our audit indicates that there is a need for clinical and cos-effective data, for these technologies, based on the daily clinical practices.…”

Section: Discussionmentioning

confidence: 99%

Current process and outcomes of the surgical management of LUTS due to benign prostatic enlargement: how consistent are we? – results from the multi-institutional audit of surgical management of BPE (AuSuM BPE) in the United Kingdom

et al. 2021

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Objective In view of changing landscape of surgical treatment for LUTS secondary to BPE, this audit was undertaken to assess key aspects of the processes and outcomes of the current interventional treatments for BPE, across different units in the UK. Materials and method A multi-institutional snapshot audit was conducted for patients undergoing interventions for LUTS/BPE over 8-week period. Using Delphi process two-part proforma was designed to capture data. Results 529 patients were included across 20 NHS trusts in England and Wales. Median age was 73 years. Indications for surgery were acute retention (47%) and LUTS (45%). 80% of patients had prior medical therapy. TURP formed the commonest procedure. 27% patients had <23 hour hospital stay. Immediate (21%) and delayed (18%) complications were Clavien-Dindo <2 category. High proportion of patients reported residual symptoms. Type and indication of surgery were significant predictor of complications, length of stay and failure of TWOC outcomes, on multivariate analyses. There were variations in departmental processes, 50% centres used PROMs. Conclusion Monopolar TURP still remains the commonest intervention for BPE. Most departments are adopting newer technologies. The audit identified opportunities for development of consistent, effective and patient centric practices as well as need for large-scale focused studies.

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Section: Discussionmentioning

confidence: 99%

Current process and outcomes of the surgical management of LUTS due to benign prostatic enlargement: how consistent are we? – results from the multi-institutional audit of surgical management of BPE (AuSuM BPE) in the United Kingdom

et al. 2021

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“…This is a small sample size of patients who received unilateral embolization, but it shows that perhaps, as has been suggested by other studies, bilateral embolization is not necessarily required to achieve adequate results. 20,29,32 Recent studies have also been performed analyzing the effects of Rezum, UroLift, and PVP therapies on IPSS and QoL scores. Rezum has been reported through multiple studies to decrease PVR between 5 and 35%, IPSS between 45 and 58%, and QoL by 38 to 61%.…”

Section: Discussionmentioning

confidence: 99%

“…IPSS and QoL were measured with questionnaires (►Table 1, ►Table 2). 20 IPSS scores ranged from 0 to 35. Data collected post-PAE were variable in time from the procedure with the majority recorded at 1-month follow-up; 3and 6-month follow-up values were recorded if available.…”

Section: Methodsmentioning

confidence: 99%

Prostatic Artery Embolization: An Alternative Treatment for Benign Prostatic Hyperplasia

Pike

Abel

Seckel

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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Purpose Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for patients with prostates >80 mL and has demonstrated lower morbidity rates. We sought to evaluate PAE at a single tertiary medical center. Methods A retrospective review of all patients who underwent PAE was completed. Demographic, clinicopathologic, procedure, and outcome data were collected to include international prostatic symptom score (IPSS) and quality of life (QoL) assessments. Results The pre-PAE mean prostate-specific antigen (PSA) was 8.4 ng/mL, mean prostate volume was 146.9 mL (9% >200 mL), and mean postvoid residual (PVR) was 208.2 mL (21.9% 200–300 mL). IPSS mean was 19.8 and QoL was “mostly dissatisfied.” Following PAE, mean PSA was reduced by 3.2 ng/mL (38.1%, p = 0.3014), the mean prostate volume reduction was 59.2 mL (40.3%, n = 19, p < 0.0001), and the average PVR reduction was 150.3 mL (72.2%, n = 27, p = 0.0002). Average IPSS score was also lower (11.9; 60.1%, n = 25, p < 0.0001) and QoL was reduced to “mostly satisfied” (p < 0.0001). Technical success was 100% with 24% minor morbidities. Conclusion PAE is a successful treatment for patients with BPH resulting in large prostates that are not good candidates for simple prostatectomy, providing optimal care with less operative and postoperative complications.

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“…When voiding symptoms are responsible for a greater proportion of the elevated IPSS score, the findings are more likely due to BPH. Conversely, if storage symptoms are elevating IPSS score, other potential causes of LUTS should be considered [ 39 ]. Such patients may benefit from further urologic evaluation such as urodynamic testing.…”

Section: Pre-procedural Patient Evaluationmentioning

confidence: 99%

Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

Naidu

Narayanan

Saini

et al. 2021

JCM

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Lower urinary tract symptoms (LUTS) due to benign prostatic hypertrophy (BPH) are a very common problem in men ranging from mild urinary symptoms to recurrent urinary tract infections or renal failure. Numerous treatment options are available ranging from conservative medical therapies to more invasive surgical options. Prostate artery embolization (PAE) has emerged as a novel treatment option for this common problem with clinical efficacy comparable to the current surgical gold standard, transurethral resection of the prostate (TURP). PAE offers fewer complications and side effects without a need for general anesthesia or hospitalization. This review discusses the indications for prostate artery embolization in addition to LUTS, patient evaluation in patients with LUTS, PAE technique and clinical results, with an emphasis on efficacy and safety.

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Prostate embolization: patient selection, clinical management and results

Cited by 14 publications

References 45 publications

Current process and outcomes of the surgical management of LUTS due to benign prostatic enlargement: how consistent are we? – results from the multi-institutional audit of surgical management of BPE (AuSuM BPE) in the United Kingdom

Current process and outcomes of the surgical management of LUTS due to benign prostatic enlargement: how consistent are we? – results from the multi-institutional audit of surgical management of BPE (AuSuM BPE) in the United Kingdom

Prostatic Artery Embolization: An Alternative Treatment for Benign Prostatic Hyperplasia

Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

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