Live from SIR 2015: Prostate artery embolization improves symptoms, regardless of enlarged prostate size

277
Sandeep Bagla
Sandeep Bagla

According to research presented at the Society of Interventional Radiology’s (SIR’s) annual scientific meeting, clinicians were able to use prostate artery embolization to improve patient symptoms, regardless of the size of benign prostatic hyperplasia before the treatment, researchers found in a retrospective study.

Sandeep Bagla, the study’s lead researcher and an interventional radiologist at Inova Alexandria Hospital, Alexandria, USA said: “This innovative treatment offers less risk, less pain and less recovery time than traditional surgery, and we are hopeful that further research will confirm it to be an effective therapy for benign prostatic hyperplasia.”

Bagla and his team examined the cases of 78 patients who underwent prostate artery embolization for benign prostatic hyperplasia as part of the clinicians’ routine practice. Patients were categorised into three different analysis groups based on the size of the enlarged prostate: less than 50 cubic centimetres, between 50 and 80 cubic centimetres and greater than 80 cubic centimetres. The researchers evaluated the effectiveness of prostate artery embolization in these patients at one, three and six months post treatment.

Ninety-six per cent of cases (75 of 78) were considered technically successful, with both blood vessels leading to the enlarged prostate blocked by treatment. The researchers found symptom improvement and that quality of life, as measured by the American Urological Association Symptom Index, significantly improved in all three patient groups. When comparing each group, there was no difference in outcome as well. Using the International Index of Erectile Function, patients also did not report a change in their sexual function. Bagla attributes this low rate of side-effects to the fact that prostate artery embolization is conducted via the femoral artery versus other treatments, which enter through the urethra or penis.

“Many men have benign prostatic hyperplasia that cannot be treated by traditional methods, such as when the benign prostate artery is smaller than 50 cubic centimetres or larger than 80 cubic centimetres,” said Bagla. “Prostate artery embolization offers these patients an effective treatment that results in reduced risk of bleeding, urinary incontinence or impotence, compared to other therapies, offering patients a better quality of life,” he added.

While the data from this research demonstrate continued symptomatic improvement six months after treatment, more research is needed to show efficacy at one year and beyond, added Bagla. He also believes that additional research—possibly randomised, prospective studies—should be done to compare the safety and efficacy of prostate artery embolization with other commonly performed benign prostatic hyperplasia treatments.


“As healthcare moves toward more patient-centred care, it is critical that interventional radiologists, in collaboration with urologists, are able to provide benign prostatic hyperplasia patients with a relatively painless, outpatient procedure,” he added.