The evaluation of super-selective prostatic arterial embolization in the treatment of benign prostatic hyperplasia

Objective To evaluate the clinical efficacy of super-selective prostatic arterial embolization(PAE) for the treatment of benign prostatic hyperplasia(BPH). Methods From February 2012 to March 2015, a total of 17 patients with BPH who failed in medical treatment, or unwilling to accept surgery were selected for PAE as the study group. The mean age was 73 years (range 61-84 years) and the mean prostatic volume was 64.6 ml(ranging 50-85 ml). The study group underwent super selective arterial embolization. The internal iliac artery angiography was performed and the main blood vessel of prostate was showed. The femoral artery was punctured under local anesthesia and X-ray monitoring, a F4-5 Cobra catheter was inserted, and then the Embosphere microspheres were implanted. A total of 40 patients who underwent transurethral resection of the prostate(TURP) were selected as the control group. The mean age was 70 years (ranging 59-87 years). The mean prostatic volume was 68.7 ml(ranging 55-90 ml). All cases were followed up for 1 year. The changes of prostatic volume(PV), international prostate symptom score(IPSS), quality of life(QOL), pre-and post-treatment peak urinary flow(Qmax) were evaluated. Results For the 17 patients who underwent PAE, the PV decreased from (64.6±10.2) ml to(42.0±7.5) ml, the IPSS decreased from 23.9±4.9 to 13.1±3.5, QOL decreased from 4.1±0.7 to 2.1±0.7, and Qmax increased from (9.5±3.7) ml/s to(21.8±4.2) ml/s, which were statistically significant (P<0.05)compared with the pre-treatment parameters. The post-operative parameters of the control group were also significantly improved compared with the preoperative parameters(P<0.05). Conclusions PAE is safe and effective in treating BPH, especially for those failing in medical treatment, or unwilling to accept surgery. Key words: Benign prostatic hyperplasia; Prostatic artery; Interventional embolization