Prostatic artery embolization safe and effective, suggests large study presented at ISET

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Francisco C Carnevale
Francisco C Carnevale

Men with benign prostatic hyperplasia can get relief from symptoms such as frequent night urination with prostatic artery embolization, suggests long-term research presented at the 26th annual International Symposium on Endovascular Therapy (ISET, 18–22 January, Miami, USA).

Prostatic artery embolization (PAE) shrinks the prostate by temporarily blocking blood flow to the arteries that feed it. Benign prostate hyperplasia affects most men as they age, including more than half by age 60 and 90% by age 85. Benign prostate hyperplasia can cause a variety of problems, including frequent urination, weak urine stream, and a constant feeling of having to urinate. It typically is treated with surgery or thermal ablation, which can cause side-effects such as retrograde ejaculation or urinary incontinence.

 

University of São Paulo physicians have treated 120 patients and 97% have reported improvement in symptoms and quality of life. Follow-up with patients ranges from three months to more than five years, with an average of 15 months. Symptoms recurred in 14% of patients, leading to re-embolization, surgery or medication therapy. 

The team from Brazil saw very few side-effects and and no major complications, although there severe complications are possible after the procedure. The technical and clinical success over 90% and mean prostate volume reduction in the reported study was 30–40%. There was significantly improvement in lower urinary tract symptoms and quality of life.

“We have treated more than 100 patients with prostate artery embolization and are encouraged by the excellent reduction in symptoms and improvement in quality of life for men who have had the procedure, including some with very large prostates, who normally would require open surgery,” said Francisco C Carnevale, associate professor of Medicine, University of São Paulo, Brazil. “None of our patients have experienced adverse side-effects, and we have followed a number of them for several years, longer than other studies.”

In the USA, prostatic artery embolization is an experimental treatment and a study is underway to compare the results of the procedure to the standard surgical treatment, transurethral resection of the prostate (TURP).