The prostate gland then begins to reduce in size relieving symptoms and improving quality of life. Long-term data regarding the efficacy of PAE is limited but studies suggest an approximately 72% success rate at 36 months . However, there is currently limited data on which patients do best following PAE and also which patients to target to this specific therapy.
Our paper  looked at which patients had the best outcome following PAE by examining quality of life questionnaires and individual MRI scans performed before and after treatment. Patients were part of the STREAM trial being run at Oxford University Hospitals, UK (Chief Investigator Dr Charles R. Tapping). We performed an age match case control study of PAE in patients with adenomatous dominant BPH versus those with non-adenomatous dominant BPH.
The technical success rate for PAE was 96% and the mean age was 68 years. There was a median reduction of 34% (30–55%) in the adenomatous dominant BPH group, compared to a volume loss of 22% (9–44%) in the non-adenomatous dominant group (p = 0.04).
More importantly, there was greater reduction in IPSS in the adenomatous dominant group. IPSS quality of life scores significantly improved in the adenomatous dominant group (p = 0.007). Whilst sexual function is not important to all men with BPH there are currently no reports of a deterioration in sexual function in the medical literature following PAE and no deterioration in sexual function was reported in our trial. This is the first time adenomatous dominant BPH has been suggested as a predictive factor in the success of PAE. Patients with adenomatous dominant BPH should be considered for PAE as a minimally invasive, low complications strategy for successful management of their BPH.
Read the Abstract
Written By: Dr Charles R. Tapping
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