Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia

J Vasc Interv Radiol. 2016 Nov;27(11):1686-1697.e8. doi: 10.1016/j.jvir.2016.08.004. Epub 2016 Oct 12.

Abstract

Purpose: To perform meta-analysis of available data on prostatic artery embolization (PAE).

Materials and methods: Meta-analysis was conducted on articles published between November 2009 and December 2015. Peer-reviewed studies with > 5 patients and standard deviations and/or individual-level data on one or more of the following outcomes were included: prostate volume (PV), peak flow rate (Qmax), postvoid residual (PVR), International Prostate Symptom Score (IPSS), quality of life (QOL) score, International Index of Erectile Function (IIEF) score, and prostate-specific antigen (PSA) level. A random-effects meta-analysis was performed on the outcomes at 1, 3, 6, and 12 months after PAE compared with baseline values, with a P < .05 decision rule as the null hypothesis rejection criterion.

Results: Nineteen of 268 studies were included in data collection, with 6 included in the meta-analysis. At 12 months, PV decreased by 31.31 cm3 (P < .001), PSA remained unchanged (P = .248), PVR decreased by 85.54 mL (P < .001), Qmax increased by 5.39 mL/s (P < .001), IPSS improved by 20.39 points (P < .001), QOL score improved by -2.49 points (P < .001), and IIEF was unchanged (P = 1.0). There were a total of 218 adverse events (AEs) among 662 patients (32.93%), with 216 being Society of Interventional Radiology class A/B (99%). The most common complications were rectalgia/dysuria (n = 60; 9.0%) and acute urinary retention (n = 52; 7.8%). No class D/E complications were reported.

Conclusions: PAE provided improvement in Qmax, PVR, IPSS, and QOL endpoints at 12 months, with a low incidence of serious AEs (0.3%), although minor AEs were common (32.93%). There was no adverse effect on erectile function.

Publication types

  • Meta-Analysis
  • Review
  • Webcast

MeSH terms

  • Arteries* / diagnostic imaging
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Humans
  • Kallikreins / blood
  • Male
  • Prostate / blood supply*
  • Prostate-Specific Antigen / blood
  • Prostatic Hyperplasia / diagnostic imaging
  • Prostatic Hyperplasia / therapy*
  • Quality of Life
  • Time Factors
  • Treatment Outcome

Substances

  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen