Comparative Study Using 100–300 Versus 300–500 μm Microspheres for Symptomatic Patients Due to Enlarged-BPH Prostates

• DOI: 10.1007/s00270-016-1443-x
• Publication Date: 2016-08-10T14:39:45Z
• Authors: Octavio Meneghell...; Francisco Cesar C...; Airton Mota Moreira; Alberto Azoubel A...; Vanessa Cristina ...; Miguel Srougi
• Keywords: Male; Acrylic Resins; Prostate; Prostatic Hyperplasia; Organ Size; Middle Aged; Prostate-Specific Antigen; Embolization, Therapeutic; Magnetic Resonance Imaging; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Lower Urinary Tract Symptoms; Quality of Life; Gelatin; Humans; Prospective Studies; Aged

The purpose of the study was to compare safety and efficacy outcomes following prostate artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 100-300 versus 300-500 μm tris-acryl gelatin microspheres.Patients were prospectively treated between August 2011 and June 2013 to receive PAE with 100-300 μm (group A) or 300-500 μm (group B) tris-acryl gelatin microspheres. Patients were followed for a minimum of 12 months and were assessed for changes in International Prostate Symptom Score (IPSS), quality of life (QoL) index, prostate volume determined by magnetic resonance imaging, serum prostate specific antigen (PSA), and maximum urine flow rate (Qmax), as well as any treatment-related adverse events.Fifteen patients were included in each group, and PAE was technically successful in all cases. Both groups experienced significant improvement in mean IPSS, QoL, prostate volume, PSA, and Qmax (p < 0.05 for all). The differences observed between the two groups included a marginally insignificant more adverse events (p = 0.066) and greater mean serum PSA reduction at 3 months of follow-up (p = 0.056) in group A.Both 100-300 and 300-500 μm microspheres are safe and effective embolic agents for PAE to treat LUTS-related to BPH. Although functional and imaging outcomes did not differ significantly following use of the two embolic sizes, the greater incidence of adverse events with 100-300 μm microspheres suggests that 300-500 μm embolic materials may be more appropriate.