Long-term outcomes of prostate artery embolization for acute urinary retention: An analysis of 88 patients

Antoine Marchi; Olivier Pellerin; Charles Querub; Marc Al Ahmar; Alessandro Di Gaeta; Carole Déan; Paul Meria; Nicolas Thiounn; Marc Sapoval; Tom Boeken

doi:10.1016/j.diii.2023.01.012

Long-term outcomes of prostate artery embolization for acute urinary retention: An analysis of 88 patients

Diagn Interv Imaging. 2023 Jun;104(6):292-296. doi: 10.1016/j.diii.2023.01.012. Epub 2023 Feb 16.

Authors

Affiliations

¹ Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou Vascular and Oncological Interventional Radiology Department, 75015 Paris, France. Electronic address: antoine.marchi@aphp.fr.
² Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou Vascular and Oncological Interventional Radiology Department, 75015 Paris, France; Université Paris Cité, 75006 Paris, France.
³ Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou Vascular and Oncological Interventional Radiology Department, 75015 Paris, France.
⁴ Assistance Publique - Hôpitaux de Paris, Hôpital Saint Louis, Urology Department, 75010 Paris, France.
⁵ Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou Urology Department, 75015 Paris, France; Université Paris Cité, 75006 Paris, France.
⁶ Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou Vascular and Oncological Interventional Radiology Department, 75015 Paris, France; Université Paris Cité, 75006 Paris, France; HeKA team, INRIA, 75015 Paris, France.

PMID: 36801097
DOI: 10.1016/j.diii.2023.01.012

Abstract

Purpose: The purpose of this study was to assess long-term outcome of prostate artery embolization (PAE) in patients presenting with acute urinary retention related to benign prostatic hyperplasia.

Materials and methods: All consecutive patients who underwent PAE for acute urinary retention due to benign prostatic hyperplasia from August 2011 to December 2021 in a single institution were retrospectively included. There were 88 men with a mean age of 72 ± 12 (standard deviation [SD]) years (range: 42-99 years). Patients underwent a first attempt of catheter removal two weeks after PAE. Clinical success was defined as the absence of acute urinary retention recurrence. Correlations between long-term clinical success and patient variables or bilateral PAE were searched for using Spearman correlation test. Catheter-free survival was assessed using Kaplan-Meier analysis.

Results: Successful catheter removal in the month following PAE was performed in 72 (72/88; 82%) patients and 16 (16/88; 18%) patients had immediate recurrence. Clinical success persisted for 58 (58/88; 66%) patients at long-term follow-up (mean follow-up: 19.5 months ± 16.5 [SD]; range: 2-74 months). Recurrence occurred at a mean of 16.2 months ± 12.2 (SD) (range: 1.5-43 months) post-PAE. Overall, 21 (21/88; 24%) patients of the cohort underwent prostatic surgery, at a mean of 10.4 months ± 12.2 (SD) (range: 1.2-42.4 months) from initial PAE. No correlations between patients variables or bilateral PAE and long-term clinical success were identified. Kaplan-Meier analysis showed a three-year catheter free probability of 60%.

Conclusion: PAE is a valuable technique for acute urinary retention related to benign prostatic hyperplasia, with a long-term success rate of 66%. However acute urinary retention relapse affects 15% of patients.

Keywords: Acute urinary retention; Bladder outflow obstruction; Long-term outcomes; Prostate artery embolization; Prostatic hyperplasia.

MeSH terms

Aged
Aged, 80 and over
Arteries
Embolization, Therapeutic* / methods
Humans
Male
Middle Aged
Prostate
Prostatic Hyperplasia* / complications
Prostatic Hyperplasia* / therapy
Retrospective Studies
Treatment Outcome
Urinary Retention* / etiology
Urinary Retention* / therapy