Abstract
Introduction
As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE.
Materials or Methods
Prospective follow-up of 86 PAE patients at a single institution between June 2012 and January 2016 was conducted (mean age 64.9 years, range 54–80 years). Multiple linear regression analysis was performed to assess strength of association between clinical improvement (change in IPSS) and other variables, of any statistical correlation, through Pearson’s bivariate analysis.
Results
No major procedural complications were identified and clinical success was achieved in 72.1% (n = 62) at 12 months. Initial prostate size and percentage reduction were found to have a significant association with clinical improvement. Multiple linear regression analysis (r2 = 0.48) demonstrated that percentage volume reduction at 3 months (r = 0.68, p < 0.001) had the strongest correlation with good symptomatic improvement at 12 months after adjusting for confounding factors.
Conclusion
Both the initial prostate size and percentage volume reduction at 3 months predict good symptomatic outcome at 12 months. These findings therefore aid patient selection and counselling to achieve optimal outcomes for men undergoing prostate artery embolisation.
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DM, NH and TB contributed to protocol development, data collection and analysis and manuscript writing; MH helped with protocol development, data analysis and manuscript writing; TD, BM contributed to data analysis and manuscript writing; SM helped with data collection and manuscript writing; and JD contributed to protocol development, data collection and analysis.
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The study complies to all regulations of the Declaration of Helsinki, and Institutional ethical approval was obtained prior to the study. Written informed consent was gained in all patients.
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Maclean, D., Harris, M., Drake, T. et al. Factors Predicting a Good Symptomatic Outcome After Prostate Artery Embolisation (PAE). Cardiovasc Intervent Radiol 41, 1152–1159 (2018). https://doi.org/10.1007/s00270-018-1912-5
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DOI: https://doi.org/10.1007/s00270-018-1912-5