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Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

  • Clinical Investigation
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Abstract

Purpose

To investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).

Materials and Methods

Twelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from the IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.

Results

The mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.

Conclusions

This is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.

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Acknowledgements

The authors wish to acknowledge the Royal College of Radiologists, UK, and Oxfordshire Health Services Research Committee (OHSRC) (Grant No. 1170) for funding the study.

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Authors and Affiliations

  1. Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    M. W. Little, P. Boardman, A. C. Macdonald, N. Taylor, R. Macpherson & C. R. Tapping

  2. Department of Urology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    J. Crew

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  1. M. W. Little
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  2. P. Boardman
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  3. A. C. Macdonald
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Correspondence to M. W. Little or C. R. Tapping.

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Little, M.W., Boardman, P., Macdonald, A.C. et al. Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study. Cardiovasc Intervent Radiol 40, 682–689 (2017). https://doi.org/10.1007/s00270-017-1602-8

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  • DOI: https://doi.org/10.1007/s00270-017-1602-8

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