Prostatic Artery Embolization in Benign Prostatic Hyperplasia Patients with High Comorbidity

Abstract

Objective: Benign prostatic hyperplasia (BPH) affects patients’ quality of life negatively. We aimed to examine the results of prostate artery embolization (PAE) treatment for BPH in the elderly patients with high comorbidity. Materials and Methods: In the present study, we evaluated the patients with lower urinary tract symptoms (LUTS) due to BPH and applied endovascular embolization treatment, who were admitted to our hospital radiology department, between February 2017 and February 2019. Patients with a high risk for surgical operation with an American Society of Anesthesiologists (ASA) score of 3 or above, International Prostate Symptom Score (IPSS) >20 and MR (Magnetic Resonance) prostate volume (PV)>70 cm3 were included in this study. In addition, maximum flow rate Qmaximum (Qmax), MRI PV and IPSS values were recorded in all patients in our clinic before PAE, and the 12th months after PAE. Results: In our study, 15 patients, who had a history of transurethral resection (TUR), and 57-82 years old (mean 73.8), participated. PAE treatment was administered to the patients who were admitted to our hospital with the diagnosis of BPH in patient high comorbidity, LUTS and high risk for open prostatectomy. In our series, Qmax, IPSS, MRI and digital subtraction angiography (DSA) findings were presented. The findings showed that pre-PAE and post-PAE at 12th month, IPSS value 25,13±1,92 and 11,4±6,51 (p=0,001), Qmax; 7,61±3,19 and 16,51±9,56 (p=0,001), MRPV; 135,47±76,48 and 83,27±43,53 (p=0,001) and also all parameters were statistically significant. Conclusion: PAE is a novel treatment modality which is increasingly being used in patients with BPH, and it is an important and effective treatment option since it is much less invasive compared to open surgery, does not require hospitalization after the procedure.