J Vasc Interv Radiol. 2021 Jul 10:S1051-0443(21)01199-4. doi: 10.1016/j.jvir.2021.06.019. Online ahead of print.
ABSTRACT
PURPOSE: To review and compare outcomes of prostatic artery embolization (PAE) with three other minimally-invasive surgical treatments for benign prostatic hyperplasia (BPH), including photo selective vaporization (PVP), prostatic urethral lift (PUL), and water vapor thermal therapy (WV) for the treatment of benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS: A literature review identified 35 publications, which included 2653 patients (studies, patients): PVP (13, 949), PUL (9, 577), WV (3, 330), PAE (10, 728). International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Quality of Life (QOL) were recorded at baseline, 6, and 12 months. Meta-analyses, pooling the standardized mean difference between pre and post-treatment scores, were conducted for each modality and time-point to assess the magnitude of a therapy’s effect to yield Pooled Effect Sizes. A negative score indicates IPSS and QOL improvement. A positive score indicates IIEF-5 improvement.
RESULTS: At 6 and 12 months, IPSS and QOL were most improved after PVP, then PAE, PUL, and lastly WV (measured only at 12 months). Between 6 and 12 months, IPSS and QOL improved with PAE, and worsened with PVP and PUL. Only PAE demonstrated statistical improvement of IIEF-5, which improved from 6 to 12 months.
CONCLUSION: PVP and PAE resulted in the largest improvements in IPSS and QOL. Only PAE resulted in improvement of IIEF-5.
PMID:34256123 | DOI:10.1016/j.jvir.2021.06.019
