Prostate artery embolization (PAE) is an emerging therapy for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
This retrospective study was conducted to assess the effect of prostate artery embolization (PAE) on erectile function in a cohort of patients with LUTS attributable to BPH at 3-months after the procedure.
A retrospective review was performed on 167 patients who underwent PAE. Data collected included Sexual Health Inventory in Men (SHIM) scores at 3, 6, and 12 months post-PAE, in conjunction with the International Prostate Symptom Scores (IPSS), Quality of Life (QoL) scores, and prostate volumes. Primary outcome was erectile function as assessed by SHIM scores at 3 months after PAE. An analysis was performed to identify patients with a ±5-point SHIM change to group them according to this minimum clinically significant difference in erectile function. Adverse events were recorded using the Clavien-Dindo (CD) classification.
At 3 months following PAE, median IPSS decreased by 16.0 [IQR, 9.0-22.0] points, median QOL decreased by 4.0 [IQR, 2.0-5.0] points, and median prostate volume decreased by 33 g [IQR, 14-55].
Median SHIM score was 17.0 [IQR, 12.0-22.0] at baseline, 18.0 [IQR, 14.0-23.0] at 3 months [P = .031], 19.0 [IQR, 14.5-21.5] at 6 months [P = .106] and 20 [IQR, 16.0-24.0] at 12 months [P = .010] following PAE. In patients with no erectile dysfunction (ED) at baseline, 21% (n = 9) reported some degree of decline in erectile function post-PAE. However, 38% (n = 40) of patients who presented with mild-to-moderate ED reported improvement in their erectile function 3 months following PAE. Overall, the changes in baseline SHIM score were relatively small; 82% (n = 137) of patients did not have more than 5 points of change in their SHIM scores at 3 months following PAE.
Our findings suggest PAE has no adverse impact on erectile function for most patients.
The study was performed at a single center with 1 operator's experience, and is retrospective with no control group.
Findings suggest that prostate artery embolization has no adverse effect on erectile function in the majority of patients with LUTS attributable to BPH at 3 months after the procedure. Bhatia S, Acharya V, Jalaeian H, et al., Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2021;XX:XXX-XXX.
The journal of sexual medicine. 2022 Feb 17 [Epub ahead of print]
Shivank Bhatia, Vedant Acharya, Hamed Jalaeian, Jessica Kumar, Evan Bryant, Andrew Richardson, Kseniia Malkova, Sardis Harward, Vishal Sinha, Issam Kably, Bruce R Kava
Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA., University of Miami, Miller School of Medicine, Miami, FL, USA., Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA. Electronic address: ., University of Massachusetts Medical School, Worcester, MA, USA., Weill Cornell Department of Radiology, New York, NY, USA., Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA.