Embolization Studies for BPH Advance
Prostate artery embolization (PAE) studies are moving forward with hopes of confirming the effectiveness and safety of early research into minimally invasive alternative current treatments for benign prostatic hyperplasia (BPH).
"As health care moves toward more patient-centered care, it's critical that interventional radiologists, in collaboration with urologists, are able to provide BPH patients with a relatively painless outpatient procedure," says Sandeep Bagla, MD, who presented data on 78 cases at SIR's annual meeting. "This innovative treatment offers less risk, less pain, and less recovery time than traditional surgery, and we are hopeful that further research will confirm it to be an effective therapy for BPH."
Bagla and his team examined the cases of 78 patients who underwent PAE for BPH as part of the clinicians' routine practice. Patients were categorized into three different analysis groups based on the size of the enlarged prostate: less than 50 cc, between 50 cc and 80 cc, and greater than 80 cc. The researchers evaluated the effectiveness of PAE in these patients at one, three, and six months post treatment.
They found that 96% of cases (75 of 78) were considered technically successful, with both blood vessels leading to the enlarged prostate blocked by PAE treatment. The researchers found symptom improvement and that quality of life, as measured by the American Urological Association Symptom Index, significantly improved in all three patient groups. When comparing each group, there was no difference in outcome as well. Using the International Index of Erectile Function, patients also did not report a change in their sexual function.
"Many men have benign prostatic hyperplasia that cannot be treated by traditional methods, such as when the BPH is smaller than 50 cubic centimeters or larger than 80 cubic centimeters," Bagla says. "Prostate artery embolization offers these patients an effective treatment that results in reduced risk of ￼bleeding, urinary incontinence, or impotence, compared to other BPH therapies, offering patients a better quality of life."
While the data from this research demonstrate continued symptomatic improvement six months after treatment, more research is needed to show efficacy at one year and beyond, Bagla says. He estimated that approximately 200 men in the United States have had the procedure. He also believes that additional research—possibly randomized, prospective studies—should be done to compare the safety and efficacy of PAE with other commonly performed BPH treatments.
BPH affects more than 50% of men ages 60 and older in the United States, and more than 80% of men 80 and older, according to Bagla.In PAE, a catheter is inserted into the femoral artery and guided to the prostate artery on both sides of the enlarged gland. Once positioned next to the prostate, microscopic spheres are delivered to block blood flow, causing the prostate to shrink. PAE is technically challenging procedure, according to Bagla.