Symptomatic Improvement of Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A Comparative Systematic Review and Meta-Analysis of Four Different Minimally Invasive Therapies.

To review and compare outcomes of prostatic artery embolization (PAE) with three other minimally-invasive surgical treatments for benign prostatic hyperplasia (BPH), including photo selective vaporization (PVP), prostatic urethral lift (PUL), and water vapor thermal therapy (WV) for the treatment of benign prostatic hyperplasia (BPH).

A literature review identified 35 publications, which included 2653 patients (studies, patients): PVP (13, 949), PUL (9, 577), WV (3, 330), PAE (10, 728). International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Quality of Life (QOL) were recorded at baseline, 6, and 12 months. Meta-analyses, pooling the standardized mean difference between pre and post-treatment scores, were conducted for each modality and time-point to assess the magnitude of a therapy's effect to yield Pooled Effect Sizes. A negative score indicates IPSS and QOL improvement. A positive score indicates IIEF-5 improvement.

At 6 and 12 months, IPSS and QOL were most improved after PVP, then PAE, PUL, and lastly WV (measured only at 12 months). Between 6 and 12 months, IPSS and QOL improved with PAE, and worsened with PVP and PUL. Only PAE demonstrated statistical improvement of IIEF-5, which improved from 6 to 12 months.

PVP and PAE resulted in the largest improvements in IPSS and QOL. Only PAE resulted in improvement of IIEF-5.

Journal of vascular and interventional radiology : JVIR. 2021 Jul 10 [Epub ahead of print]

Samuel LaRussa, Morgan Pantuck, Rand Wilcox Vanden Burg, Christopher Daniel Gaffney, Gulce Askin, Timothy McClure

Department of Interventional Radiology, Weill Cornell Medicine / New York Presbyterian, New York, NY USA; Department of Radiology, Einstein-Jacobi Medical Center, Bronx, NY USA., Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA., Department of Urology, Weill Cornell Medicine / New York Presbyterian, New York, NY USA., Division of Biostatistics, Department of Population Health Sciences, and Weill Cornell Medicine, New York, NY, USA., Department of Interventional Radiology, Weill Cornell Medicine / New York Presbyterian, New York, NY USA; Department of Urology, Weill Cornell Medicine / New York Presbyterian, New York, NY USA. Electronic address: .

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