To evaluate the safety and efficacy of repeat prostatic artery (PA) embolization (PAE) for benign prostatic hyperplasia (BPH).
A single-center retrospective study was conducted from 2009 to 2018 in 108 patients with symptomatic BPH treated with repeat PAE: group A (n = 39; 36. 1%) were patients who never showed a response to PAE, and group B (n = 69; 63.9%) were patients who had clinical improvement in the first 6 months following PAE but relapsing symptoms afterward. The main patterns of revascularization were 75% from the previously embolized PA and 25% from collateral vessels (superior vesical, posterior-lateral PA, penile branches). Technical outcomes and adverse events were registered. International Prostate Symptom Score (IPSS), quality of life (QOL), and clinical success were compared between groups.
Median follow-up was 18 months (range, 1-36 mo); median interval between PAE and repeat PAE was 420 days (range, 77-2,240 d). Mean procedural time was significantly longer for repeat PAE vs initial PAE (81.1 min vs 67.4 min; P = .0007). There were no major complications and no urinary incontinence. Mean IPSS/QOL improvements were greater in group B vs group A: 9.51 vs 6.13 and 1.30 vs 0.56, respectively (P < .001). The cumulative probability of clinical success after repeat PAE was higher in group B than in group A (P = .0001): 84.1% vs 46.2% at 1 month, 56.7% vs 28.2% at 12 months, and 51.9% vs 16.9% at 24-36 months.
Repeat PAE is safe and effective for recurrence of lower urinary tract symptoms caused by BPH but has limited impact in patients who did not show a response to initial PAE.
Journal of vascular and interventional radiology : JVIR. 2020 Aug [Epub]
Nuno V Costa, Daniel Torres, João Pisco, Luis C Pinheiro, Francisco E Martins, António G Oliveira, Tiago Bilhim
Interventional Radiology Department, Hospital Saint Louis, Rua Luz Soriano 182, 1200-249 Lisbon, Portugal; Radiology Department, Nova Medical School, Lisbon, Portugal; Interventional Radiology Unit, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal., Interventional Radiology Department, Hospital Saint Louis, Rua Luz Soriano 182, 1200-249 Lisbon, Portugal., Urology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal., Urology Department, Hospital Saint Louis and Santa Maria Hospital, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal., Department of Pharmacy, Universidade Federal do Rio Grande do Norte, Natal, Brazil., Interventional Radiology Department, Hospital Saint Louis, Rua Luz Soriano 182, 1200-249 Lisbon, Portugal; Radiology Department, Nova Medical School, Lisbon, Portugal; Interventional Radiology Unit, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal. Electronic address: .