Format

Send to

Choose Destination
Cardiovasc Intervent Radiol. 2020 Jan 2. doi: 10.1007/s00270-019-02398-0. [Epub ahead of print]

Improvements in Irritative Versus Obstructive Symptoms of the International Prostate Symptom Score After Prostatic Artery Embolization in 174 Patients, in a Single Center.

Author information

1
Interventional Radiology and Endovascular Surgery Department, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, 05403-000, São Paulo, SP, Brazil. airton.mota@criep.com.br.
2
Interventional Radiology and Endovascular Surgery Department, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, 05403-000, São Paulo, SP, Brazil.
3
Urology Department, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, 05403-000, São Paulo, SP, Brazil.

Abstract

AIM:

The aim of this study is to compare the improvements in irritative versus obstructive symptoms of the International Prostate Symptom Score (IPSS) after prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS:

Between 2010 and 2018, 186 patients underwent PAE in a single center and 174 patients were retrospectively selected. The inclusion criteria were symptoms due to BPH, refractory to pharmacological treatment and IPSS ≥ 8. The mean age of the patients was 63.7 ± 7.2 years, the mean prostate volume 89.5 ± 42.5 cm3, and the mean IPSS 19.0 ± 6.2 points. Patient data were reviewed at baseline, 3, 12 and 24 months and compared using the ANOVA mixed models and the Tukey's multiple comparison test.

RESULTS:

Obstructive subscores dropped more significantly than irritative subscores (p < 0.0001). The mean decrease in each IPSS item was frequency 2.4 (83%); urgency 0.8 (87%); nocturia 1.3 (49%); incomplete emptying 2.6 (83%); intermittency 2.3 (91%); weak stream 2.9 (82%); straining 1.6 (91%). The area under the curve for baseline obstructive scores was 0.7 (p = 0.006) and 0.59 (p = 0.182) for irritative scores. The most common BPH clinical manifestations include irritative and/or obstructive symptoms, the latter usually more prevalent. The IPSS drop observed after PAE suggests that it acts predominantly over obstructive symptoms (p < 0.0001).

CONCLUSION:

Although a predominant improvement in obstructive symptoms may be observed after PAE, nocturia complaints may require special attention. The severity of baseline obstructive symptoms may significantly predict clinical outcomes.

KEYWORDS:

Benign prostatic hyperplasia; Embolization; Imaging; International prostate symptom score; Interventional radiology; Lower urinary tract symptoms; Prostate artery embolization

PMID:
31897620
DOI:
10.1007/s00270-019-02398-0

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center