To characterize voiding and storage symptom domain-specific outcomes after prostate artery embolization (PAE) to treat lower urinary tract symptoms (LUTS) or urinary retention caused by benign prostatic hyperplasia (BPH).
240 patients (age=74.5±8.6 years) underwent PAE between May 2013 and March 2020 at a single center for LUTS (n=161) or urinary retention (n=79). Total International Prostate Symptom Score (IPSS-t), voiding domain score (IPSS-v), storage domain score (IPSS-s), and Quality of Life score (QoL) were obtained pre-PAE for LUTS patients (IPSS-t=21.7±6.2, IPSS-v=11.9±4.3, IPSS-s=9.6±3.1, QoL=4.5±1.2), and post-PAE through 36 months (mean=22.9±15.2 months) for LUTS and retention patients. Mean relative changes in IPSS-t, IPSS-v, IPSS-s, and QoL were calculated for LUTS patients. Mean voiding or storage component scores were calculated for retention patients.
For evaluable LUTS patients (n=147), IPSS-t showed sustained substantial improvement through 36 months (6.3±4.2-8.6±7.6), as did QoL (1.1±1.1-1.8±1.5). One month after PAE, improvements in IPSS-v (69%±29%) were greater than in IPSS-s (46%±33%)(P<0.000001), and remained so through 36 months (68%±31% vs. 53%±28%, P=0.004). Among evaluable retention patients (n=75), 84% passed voiding trials. Both IPSS-t (6.0±3.9-8.2±6.7) and QoL (0.9±1.2-1.5±1.6) remained low through 36 months. One month after PAE, mean IPSS-v component score (0.9±1.3) was lower than mean IPSS-s component score (1.7±1.4)(P=0.003) and remained so through 24 months (0.9±1.2 vs. 1.3±1.1, P=0.02), with similar trend at 36 months (0.7±1.1 vs. 1.1±1.1, P=0.07).
PAE effectively treated BPH-related LUTS and retention. IPSS-v improved more than IPSS-s in LUTS patients, and remained lower in LUTS and retention patients through 36 months.
Urology. 2021 May 04 [Epub ahead of print]
Raj Ayyagari, Taylor Powell, Lawrence Staib, Bing Liu, Shivank Bhatia, Toby Chai
Yale University School of Medicine. Electronic address: ., Yale University School of Medicine. Electronic address: ., Yale University School of Medicine. Electronic address: ., Yale University School of Medicine. Electronic address: ., University of Miami School of Medicine. Electronic address: ., Yale University School of Medicine. Electronic address: .