Prostate artery embolization using n-butyl cyanoacrylate glue for symptomatic benign prostatic hyperplasia: A six-month outcome analysis in 103 patients - 30/03/24
, Alexis Quirantes a, Kévin Guillen a, b, Amin Mazit a, Pierre-Olivier Comby b, c, Ludwig Serge Aho-Glélé d, Olivier Chevallier a, b
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Highlights |
• | Prostatic artery embolization with N-butyl cyanoacrylate is safe and yields significant improvements in international prostate symptoms score, international prostate symptoms score-quality of life, prostate-specific antigen level, and prostate volume in patients with symptomatic benign prostatic hyperplasia from baseline to six months. |
• | N-butyl cyanoacrylate for prostatic artery embolization has many important advantages over particulate embolic agents, such as faster intervention, limited radiation dose, and excellent radiological visibility profile. |
• | Prospective studies in larger samples, with longer follow-up durations and comparisons of different embolic agents for prostatic artery embolization should be performed. |
Abstract |
Purpose |
The purpose of this study was to assess the feasibility, safety, and 6-month outcomes of prostate artery embolization (PAE) using N-butyl-cyanoacrylate (NBCA) glue as the only embolic agent in patients with benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms.
Materials and methods |
Patients with BPH-related lower urinary tract symptoms who were treated by PAE using methacryloxysulfolane-NBCA mixed with ethiodized oil (1:8 ratio) between September 2018 and January 2023 were retrospectively included. Vascular mapping was made using cone-beam computed tomography angiography. PAEs were performed as an outpatient procedure, under local anaesthesia. Outcomes were assessed at six months using the International Prostate Symptoms Score (IPSS) and associated quality-of-life score (IPSS-QoL), prostate-specific antigen (PSA) level, prostate volume, and International Index of Erectile Function form 5 (IIEF5).
Results |
A total of 103 men with a mean age of 68.4 ± 6 (standard deviation [SD]) years were included. Technical success rate was 100%. The mean fluoroscopy time was 26.4 ± 12.5 (SD) min and the median radiation dose was 23 980 mGy·cm (Q1, Q3: 16 770, 38 450). Compared to baseline, statistically significant improvements were observed at six months for the IPSS (8.9 ± 6.2 [SD] vs. 20.2 ± 6.5 [SD]; P = 0.01), IPSS-QoL (2.1 ± 1.4 [SD] vs. 5.1 ± 0.9 [SD]; P = 0.01), PSA level (3.6 ± 3.2 [SD] ng/mL vs. 4.8 ± 4.2 [SD] ng/mL; P = 0.0001), and prostate volume (78.6 ± 43.5 [SD] mL vs. 119.1 ± 65.7 [SD] mL; P = 0.01). Minor adverse events developed in 19/103 (18.4%) patients. No major complications occurred. Compared to baseline, the IIEF5 did not change significantly at six months (15.3 ± 6.8 [SD] vs. 15.8 ± 6.8 [SD]; P = 0.078).
Conclusion |
PAE with NBCA is a feasible and safe method that provides good outcomes at six months in patients with BPH-related lower urinary tract symptoms. This method deserves further evaluation in randomized trials with longer follow-up.
El texto completo de este artículo está disponible en PDF.Keywords : Benign prostate hyperplasia, Cyanoacrylates, Lower urinary tract symptoms, Outcome studies, Prostate artery embolization
Abbreviations : BPH, CI, IIEF, IPSS, LUF, LUTS, MS-NBCA, NBCA, PAE, PSA, QoL, SD, SIR, TURP
Esquema
Vol 105 - N° 4
P. 129-136 - avril 2024 Regresar al número
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