Association between intravesical prostatic protrusion and clinical outcomes in prostatic artery embolization - 25/02/21
, Alessandro Di Gaeta a, b, Nadia Moussa a, b, Constantino Del Giudice a, b, Carole Dean a, Olivier Pellerin a, b, c, Marc Sapoval a, b, c
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Highlights |
• | Intra vesical prostatic protrusion is not a prognostic marker of ineffective prostatic artery embolization (PAE) in men with benign prostatic hyperplasia. |
• | Severe protrusion could lead to better response to PAE though expected prostate height reductions are mild. |
• | Specific techniques of PAE for severe prostatic protrusions should be further investigated. |
Abstract |
Purpose |
To evaluate the influence of intravesical prostatic protrusion (IPP) on clinical outcomes after prostatic artery embolization (PAE) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia.
Materials and methods |
All consecutive patients who underwent PAE for lower urinary tract symptoms between January 2017 and January 2019 were retrospectively included. IPP was evaluated on pre-treatment magnetic resonance imaging examination and symptoms were assessed at follow-up consultations using the international prostate symptom score (IPSS) and quality of life (QOL) questionnaire. IPPs were classified as grade 1 (<5mm), grade 2 (5–10mm), or grade 3 (>10mm).
Results |
A total of 160 consecutive men (mean age 65±7.8 [SD] years; range: 45–89 years), underwent PAE. The mean IPSS was 21±7.3 (SD) (range: 5–35) and prostate volume 87±38 (SD) mL (range: 30–200mL). The IPP grade was 1 for 28 (28/160; 18%), 2 for 52 (52/160; 33%), and 3 for 80 (80/160; 50%) patients. There were no significant differences in IPSS at baseline between the three IPP grades. Patients with severe (grade 3) IPP had a significantly higher reduction in IPSS than those with non-severe IPP (grade 1 or 2), with estimated mean reductions of 12±2.5 (SD) (range: −4–28) and 8.3±1.9 (SD) (range: −8–21) (P=0.02), respectively. The mean reduction in the QOL score was 3.0 for grade 3 and 2.0 for grade 1 or 2 IPP (P=0.02).
Conclusions |
The degree of IPP does not limit the efficacy of PAE in patients with lower urinary tract symptoms due to benign prostatic hyperplasia.
El texto completo de este artículo está disponible en PDF.Keywords : Embolization, Interventional radiology, Lower urinary tract symptoms, Prostatic hyperplasia, Quality of life
Abbreviations : IIEF, IPP, IPSS, LUTS, MRI, PAE, PSA, Qmax, QOL, SD
Esquema
Vol 102 - N° 3
P. 141-145 - mars 2021 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.