Introduction: Prostatic artery embolization (PAE) has recently started to be viewed as a promising technology that could be an alternative to different treatment options of benign prostatic hyperplasia (BPH), especially in high-risk patients. The aim of our study was to evaluate the efficacy and safety of PAE in BPH patients who are at high risk for surgery and/or anesthesia. Materials and Methods: Between June 2013 and February 2015, BPH patients >50 years with lower urinary tract symptoms (LUTS) refractory to BPH-related medical therapy or had an indwelling urethral catheter due to refractory urine retention were prospectively enrolled in the study. All patients were at high risk for surgery and/or anesthesia. The PAE was performed and the embolising material used was biosphere 300-500 µm particles. Pre- and 1, 3, 9 months post-intervention, all patients were assessed by detailed medical history, physical examination, serum prostate-specific antigen (PSA), uroflowmetry, and abdominal and transrectal ultrasonography. Results: Twenty-two consecutive patients with a mean age of 72.50 years and a mean prostate volume of 77.30 ± 14.89 cm3 were included. The PAE procedure was successful in all patients. Throughout the period of follow-up, there was a significant improvement in the LUTS and urinary flow rate, and reduction in prostate volume and serum PSA (for all p < 0.001). No major complications were reported. Conclusion: Our results show that BPH patients with failed medical treatment who are at high risk for surgery and/or anesthesia could be treated safely and effectively through PAE.

1.
Wallner LP, Slezak JM, Loo RK, Quinn VP, Van Den Eeden SK, Jacobsen SJ: Progression and treatment of incident lower urinary tract symptoms (LUTS) among men in the California men's health study. BJU Int 2015;115:127-133.
2.
Grosso M, Balderi A, Arnò M, Sortino D, Antonietti A, Pedrazzini F, Giovinazzo G, Vinay C, Maugeri O, Ambruosi C, Arena G: Prostatic artery embolization in benign prostatic hyperplasia: preliminary results in 13 patients. Radiol Med 2015;120:361-368.
3.
Roehrborn CG, Rosen RC: Medical therapy options for aging men with benign prostatic hyperplasia: focus on alfuzosin 10 mg once daily. Clin Interv Aging 2008;3:511-524.
4.
Carnevale FC, Antunes AA, da Motta Leal Filho JM, et al: Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol 2010;33:355-361.
5.
Varkarakis J, Bartsch G, Horninger W: Long-term morbidity and mortality of transurethral prostatectomy: a 10-year follow-up. Prostate 2004;58:248-251.
6.
Pisco JM, Pinheiro LC, Bilhim T, Duarte M, Mendes JR, Oliveira AG: Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol 2011;22:11-19; quiz 20.
7.
Demeritt JS, Elmasri FF, Esposito MP, Rosenberg GS: Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol 2000;11:767-770.
8.
Sun F, Sánchez FM, Crisóstomo V, et al: Benign prostatic hyperplasia: transcatheter arterial embolization as potential treatment - preliminary study in pigs. Radiology 2008;246:783-789.
9.
Jeon GS, Won JH, Lee BM, et al: The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: a pilot study. J Vasc Interv Radiol 2009;20:384-390.
10.
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA, Baroni RH, Marcelino AS, Cerri LM, Yoshinaga EM, Cerri GG, Srougi M: Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol 2013;24:535-542.
11.
Madersbacher S, Marberger M: Is transurethral resection of the prostate still justified? Brit J Urol Int 1999;83:227-237.
12.
May F, Hartung R: Surgical treatment of BPH: technique and results. EAU Update Series 2004;2:15-23.
13.
Levy A, Samraj GP: Benign prostatic hyperplasia: when to ‘watch and wait,' when and how to treat. Cleve Clin J Med 2007;74(suppl 3):S15-S20.
14.
Thorpe A, Neal D: Benign prostatic hyperplasia. Lancet 2003;361:1359-1367.
15.
European Association of Urology: EAU Guidelines, Edition Presented at the 25th EAU Annual Congress, Barcelona, 2010. Arnhem, EAU Guidelines Office, 2010.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.