Research that will be presented Wednesday at SIR 2017 shows that prostate artery embolization (PAE) reduces urinary tract symptoms for men with enlarged prostates and maintains its effectiveness for at least 3 years after patients undergo the therapy.
This study of 1,000 men is the largest of its kind to evaluate the long-term effectiveness of PAE. Researchers also found that PAE, developed and performed by interventional radiologists, is especially effective in men with BPH who also have acute urinary retention or the inability to voluntarily urinate and in patients with very large prostates who are normally treated with open surgery.
“Short-, medium- and long-term outcomes of prostate artery embolization for patients with benign prostatic hyperplasia: 1,000 patients” is one of the three abstracts featured during Wednesday’s plenary session. The session starts at 10:30 a.m. in the Ballroom.
“Prostate artery embolization gives men with BPH a treatment option that is less invasive than other therapies and allows them to return to their normal lives sooner,” said João Martins Pisco, MD, an interventional radiologist at St. Louis Hospital in Lisbon, Portugal, and the study’s lead author. “Time and time again, I see patients who are relieved to find out about PAE because they are not able to tolerate medications for BPH due to their side effects. These men also don’t want traditional surgery because it involves greater risks, has possible sexual side effects, and has a recovery time that is relatively long compared to PAE, which is generally performed under local anesthesia and on an outpatient basis.”
Between March 2007 and March 2016, 1,000 men underwent PAE. All those patients, who averaged 67 years of age, were evaluated at 1, 3 and 6 months (short-term outcomes), 807 patients were seen every 6 months between 6 months and 3 years (medium-term outcomes), and 406 patients were evaluated every year after 3 years (long-term outcomes).
During each evaluation, the men’s symptoms were measured by the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF). Researchers also measured the size of the prostate and the amount of urine left in the bladder after urination. They also evaluated the peak urinary flow rate and the prostate-specific antigen (PSA) level, a test used to screen for prostate cancer.
At the short-term mark, the treatment had an 89 percent cumulative success rate — measuring the success across all variables through the given testing period. The 807 men evaluated at the medium-term mark had an 82 percent success rate. And of the 406 patients measured at the long-term mark, 78 percent were considered cumulative successes.
The team also performed PAE in 210 patients who had limited treatment options due to extreme enlargement of the prostate (larger than 100 cm³). Of these men, 84 percent experienced cumulative success at short-term evaluation, as did 76.2 percent at medium- and long-term evaluation.
While PAE proved highly successful in this research, Dr. Pisco noted that the treatment might not be appropriate for all patients, such as those with advanced arterial atherosclerosis that may be due to smoking or diabetes.