Efficacy and safety of prostate artery embolization for patients with lower urinary tract symptoms and indwelling urinary catheter: A retrospective multicenter study - 29/11/22
, Asmaa Belaouni a, 1, Olivier Pellerin b, Nicolas Thiounn c, Chris Serrand d, Stéphane Droupy e, François Petitpierre f, Hélène Vernhet-Kovacsik g, Thibaut Murez h, Vincent Vidal i, Julien Ghelfi j, Gaele Pagnoux k, Ricardo Codas l, Hélène de Forges a, Jean-Paul Beregi a, Marc Sapoval b
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Highlights |
• | A multicenter study involving 383 patients shows that prostate artery embolization (PAE) is safe and effective for the treatment of benign prostatic hyperplasia. |
• | PAE is feasible in many centers with various experiences in PAE treatment, with no differences in outcome between centers. |
• | Presence of cardiovascular comorbidities (including diabetes, history of stroke, myocardial infarction and lower limb artery disease) is the single independent variable inversely associated with PAE success. |
Abstract |
Purpose |
The purpose of this multicenter study was to evaluate the clinical success at three months of prostate artery embolization (PAE), assess PAE safety in centers with various experiences and identify factors associated with PAE success.
Patients and methods |
This multicenter, retrospective study included patients who underwent PAE for lower urinary tract symptoms (LUTS) including those with indwelling urinary catheter. PAE clinical success was defined as either 25% improvement of the International Prostate Symptom Score (IPSS) or 1-point improvement of quality of life (QoL) score, or catheter removal at three months. Multivariable analyses were performed using a logistic regression adjusted on patient variables, technical parameters and center experience in PAE.
Results |
A total of 383 men (mean age, 68.4 ± 9.7 [standard deviation] years; range: 46–94) with LUTS, including 99 (25.8%) patients with indwelling urinary catheter, were included in seven centers from January 2017 to March 2019. Five patients reported major complications (1.3%), three (0.8%) penile ulceration, three (0.8%) acute urinary retention, one (0.3%) prostatic abscess, and 56 (14.6%) minor complications. Follow up data were available for 271 patients (center 1: n = 159; other centers: n = 112). Clinical success was reported in 232 patients (85.6%). In multivariable analyses, presence of cardiovascular comorbidities (diabetes, stroke history, myocardial infarction and lower limb artery disease) was the single independent variable inversely associated with PAE clinical success (odds ratio = 0.396; 95% confidence interval: 0.17–0.91; P = 0.029). There was no center effect.
Conclusion |
Our results show that PAE is safe and effective in centers with various PAE experiences. Cardiovascular comorbidity is the single independent variable associated with PAE failure.
Le texte complet de cet article est disponible en PDF.Keywords : Benign prostatic hyperplasia, Prostatic artery embolization, Lower urinary tract symptoms, Predictive factors
Abbreviations : BPH, CI, IPSS, LUTS, OR, PAE, QoL, SD
Plan
Vol 103 - N° 12
P. 601-606 - décembre 2022 Retour au numéro
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