Prostatic Arterial Embolization vs Open Prostatectomy: A 1-Year Matched-pair Analysis of Functional Outcomes and Morbidities - 21/08/15
, Dmitry Kurbatov b, Salvatore Sansalone c, Alexander Lepetukhin b, Sergey Dubsky b, Ivan Sitkin b, Costanza Salamone a, Livio Fiorino a, Roman Rozhivanov b, Sebastiano Cimino a, Giuseppe Morgia aAbstract |
Objective |
To evaluate 1-year surgical and functional results and morbidities of prostatic artery embolization (PAE) vs open prostatectomy (OP).
Patients and Methods |
We undertook 1:1 matched-pair analysis (International Prostate Symptom Score [IPSS], peak flow [PF], postvoid residual [PVR], and prostate volume) of 287 consecutive patients treated for benign prostatic obstruction, including 80 OP and 80 PAE. Inclusion criteria were as follows: lower urinary tract symptoms or benign prostatic obstruction, IPSS ≥12, prostate-specific antigen (PSA) <4 ng/mL, or PSA between 4 and 10 ng/mL but negative prostate biopsy, total prostate volume >80 cm3, and PF <15 mL/s. Follow-up was performed at 1 month, 6 months, and 1 year at clinic. Primary end points of the study were the comparison regarding IPSS, International Index of Erectile Function-5, PF, PVR, and IPSS quality of life (IPSS-QoL) after 1 year of follow-up.
Results |
Regarding primary end points, OP group had lower IPSS (4.31 vs 10.40; P <.05), 1-year PVR (6.15 vs 18.38; P <.05), 1-year PSA (1.33 vs 2.12; P <.05), IPSS-QoL (0.73 vs 2.78; P <.05), International Index of Erectile Function-5 (10.88 vs 15.13; P <.05), and greater PF (23.82 vs 16.89; P <.01). The matched-pair comparison showed higher value of postoperative hemoglobin level (mg/dL) and shorter hospitalization (days) and catheterization (days) for PAE group. At the multivariate logistic regression, PAE was associated with persistent symptoms (IPSS ≥8; odds ratio, 2.67; 95% confidence interval [CI], 0.96-7.4; P <.01) and persistent PF ≤15 mL/s (odds ratio, 4.95; 95% confidence interval, 1.73-14.15; P <.05) after 1 year.
Conclusion |
PAE could be considered a feasible minimally invasive technique but failed to demonstrate superiority to OP because of the increased risk of persistent symptoms and low PF after 1 year.
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| Giorgio Ivan Russo had full access to data. Dmitry Kurbatov, Alexander Lepetukhin, Sergey Dubsky, Ivan Sitkin, Costanza Salamone, Livio Fiorino, and Roman Rozhivanov collected data. Giorgio Ivan Russo designed the study, analyzed and interpreted data, performed statistical analysis, and drafted the article. Sebastiano Cimino, Salvatore Sansalone, and Giuseppe Morgia supervised for intellectual contents. |
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| Financial Disclosure: The authors declare that they have no relevant financial interests. |
Vol 86 - N° 2
P. 343-348 - août 2015 Retour au numéro
Article précédent
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