Prostatic artery embolization versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia: 12 month results of a clinical trial

Giral Villalta P.J. ¹,
Aguilar Guevara J.F. ¹,
López Ubillos G. ¹,
Lacarra Fernández S. ¹,
Zabalo San Juan A. ¹,
Asiáin Urmeneta M. ¹,
Meza Huamán A.M. ¹,
Sazatornil Escuer M. ¹,
Insausti Gorbea I. ²,
Sáez De Ocáriz García A. ²,
Solchaga Álvarez S. ²,
Napal Lecumberri S. ¹,
Cebrián Lostal J.L. ¹,
Losada Álvarez I. ¹

¹ Complejo Hospitalario de Navarra, Dept. of Urology, Pamplona, Spain ² Complejo Hospitalario de Navarra, Dept. of Interventional Radiology, Pamplona, Spain

Abstract

Introduction & Objectives

Benign prostatic hyperplasia (BPH) is a prevalent disease associated with lower urinary tract symptoms (LUTS). The gold standard for the treatment of LUTS unresponsive to pharmacological treatment is the transurethral resection of the prostate (TURP). This intervention is not exempt from complications. Prostatic artery embolization (PAE) has been described as a new, effective and safe procedure for the treatment of LUTS secondary to BPH.

Materials & Methods

This is a prospective, randomized, non-inferiority clinical trial comparing efficacy and safety of PAE and TURP in the treatment of BPH-related LUTS. A total of 60 patients, from the urology clinics, diagnosed with BPH with obstructive moderate or severe LUTS refractory to medical therapy and candidate to TURP were randomized to either PAE or TURP. The objectives and variables are shown in the table 1. The patient have to meet all the inclusion criteria and no one of the exclusion criteria (Table 1).

This clinical study had been approved by the local ethics committee.

Results

The study results are shown in figure 1.

The adverse events are shown in the figure 2.

Conclusions

The PAE is a safe and effective treatment for the LUTS related to BPH. There is evidence of non inferiority of the PAE front of TURP. Although bigger, multicenter, and with longer follow up studies are needed.