AUTHOR=Bertolo Riccardo , Cipriani Chiara , Giuliani Maria Silvia , Maiorino Francesco , Vittori Matteo , Carilli Marco , Signoretti Marta , Minucci Sergio , Bove Pierluigi 

TITLE=Prostatic arterial embolization as a micro-invasive treatment option for benign prostatic obstruction: A subtle balance between short-term follow-up patient-reported outcomes and de-obstructive effectiveness

JOURNAL=Frontiers in Urology

VOLUME=Volume 2 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/urology/articles/10.3389/fruro.2022.960875

DOI=10.3389/fruro.2022.960875

ISSN=2673-9828

ABSTRACT=Purpose: To evaluate the effectiveness of prostatic arterial embolization (PAE) in the relief from benign prostatic obstruction (BPO) beyond the patient-reported outcomes.
Methods: Retrospective evaluation of patients who underwent PAE (Mar 2015 – Dec 2019). All patients underwent prostate MRI to assess prostate volume (PVol), uroflowmetry to assess Qmax and were administered IPSS + QoL. 3 months postoperatively, MRI, and IPSS were repeated. Patients were contacted for urological consultation including uroflowmetry with post-voiding residual volume (PVR), IPSS + QoL. In addition, patient satisfaction was assessed. Sexual function including ejaculation and complications were recorded.
Results: Fifty-two patients were analyzed. At baseline, PVol was 66 ml (IQR 48-67), Qmax 13.5 ml/s (IRQ 11.5-19), IPSS 23 (IQR 18-25) and QoL 4.5 (IQR 4-5). At 3-months follow-up, MRI showed a 27% (IQR 18-36) reduction in PVol (p<0.001). IPSS decreased by 81% (IQR 58-91, p < 0.001). At a median follow-up of 14 months (IQR 10.5-27.5), IPSS decreased by 40% (IQR 26-54, p < 0.001) and QoL by 50% (IQR 20-75, p = 0.002) versus baseline. Absolute Qmax was 12.2 ml/s (IQR 9.5-14). Median %variation of Qmax vs baseline was -7.3% (IQR -33.9; +25.5, p = 0.7). 
All sexually-active patients maintained ejaculation. 38 (73%) were satisfied with treatment received. One patient reported post-operative erectile dysfunction. All patients who were counseled for adjuvant endoscopic treatment refused surgery except by one.
Conclusion: In our analysis PAE provided significant improvement in the short-term follow-up patient-reported outcomes. Most patients were satisfied, and ejaculation was maintained. On the other hand, effectiveness of PAE on the relief of BPO seemed virtually intangible in most of the cases.