Role of Prostatic Artery Embolization in Management of Benign Prostatic Hyperplasia

Abstract

Islam M. Allam, Osama M. Hetta, Ahmed H. Soliman, and Ayman M.Ibrahim.

Background: Prostatic artery embolization is one of the most recent emerging and sophisticated interventional radiology procedures. Prostatic artery embolization is a minimally invasive procedure in management of lower urinary tract symptoms due to benign prostatic hyperplasia after failure of medical management. It represents a safer choice as compared to the usual surgical procedures used in this case. Under local anesthesia via femoral artery puncture catheter navigation is performed under fluoroscopy guidance to catheterize prostatic arteries followed by embolization of the prostatic bed aiming to reduction of the prostatic size and thus reliving the lower urinary tract symptoms. The aim of this study is to evaluate efficacy of prostate artery embolization in managing benign prostatic hyperplasia presented with clinically significant lower urinary tract symptoms. In our study prostatic artery embolization was performed on 20 benign prostatic hyperplasia patients, (mean age, 65.3 years; range, 59 – 77 years). The mean prostatic volume measured were 95.95 ml, (range 52-180 ml). The mean scoring of LUTS were (IPSS =19.35) and (QOL =4.35), with range of (IPSS 7-31) and (QOL 3- 5). Four of them complained of urinary retention and were already catheterized during procedure
Results: There are statistically significant differences (P values < 0.05) between (International prostatic scoring system, quality of life, Prostate volume and post-voiding urine volume) of the same patient before and after Prostatic artery embolization.
Conclusion: Prostatic artery embolization is efficient procedure in management of benign prostatic hyperplasia, significantly reducing the prostatic volume, post-voiding residual urine volume and patient’s lower urinary tract symptoms.