Efficacy and safety of prostate artery embolization for patients with lower urinary tract symptoms and indwelling urinary catheter: A retrospective multicenter study

Julien Frandon; Asmaa Belaouni; Olivier Pellerin; Nicolas Thiounn; Chris Serrand; Stéphane Droupy; François Petitpierre; Hélène Vernhet-Kovacsik; Thibaut Murez; Vincent Vidal; Julien Ghelfi; Gaele Pagnoux; Ricardo Codas; Hélène de Forges; Jean-Paul Beregi; Marc Sapoval

doi:10.1016/j.diii.2022.07.002

Efficacy and safety of prostate artery embolization for patients with lower urinary tract symptoms and indwelling urinary catheter: A retrospective multicenter study

Diagn Interv Imaging. 2022 Dec;103(12):601-606. doi: 10.1016/j.diii.2022.07.002. Epub 2022 Aug 10.

Authors

Julien Frandon¹, Asmaa Belaouni², Olivier Pellerin³, Nicolas Thiounn⁴, Chris Serrand⁵, Stéphane Droupy⁶, François Petitpierre⁷, Hélène Vernhet-Kovacsik⁸, Thibaut Murez⁹, Vincent Vidal¹⁰, Julien Ghelfi¹¹, Gaele Pagnoux¹², Ricardo Codas¹³, Hélène de Forges², Jean-Paul Beregi², Marc Sapoval³

Affiliations

¹ Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, IMAGINE, 30029 Nîmes, France. Electronic address: jfrandon38@gmail.com.
² Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, IMAGINE, 30029 Nîmes, France.
³ Department of Interventional Radiology, Hôpital Européen Georges Pompidou, AP-HP, INSERM U970, Université Paris Cité, Faculté de Médecine, 75006 Paris, France.
⁴ Department of Urology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, 75006 Paris, France.
⁵ Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology (BESPIM), CHU Nîmes, 30029 Nîmes France.
⁶ Department of Urology, Nîmes University Hospital, University of Montpellier, 30029 Nîmes, France.
⁷ Department of Diagnostic and Interventional Imaging, Groupe Hospitalier Pellegrin, 33000 Bordeaux, France.
⁸ Department of Radiology, CHU de Montpellier, Arnaud de Villeneuve Hospital, University of Montpellier, 34090 Montpellier, France.
⁹ Department of Urology, CHU de Montpellier, Lapeyronie Hospital, University of Montpellier, 34295 Montpellier, France.
¹⁰ Department of Diagnostic and Interventional Imaging, AP-HM, Hôpital de La Timone; Université Aix-Marseille, CERIMED, Faculté de Médecine, EA 4264, Laboratoire d'Imagerie Interventionnelle Expérimentale, 13005 Marseille, France.
¹¹ Department of Diagnostic and Interventional Imaging, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U 1209, 38700 La Tronche, France.
¹² Service d'Imagerie Urinaire et Vasculaire, Hospices Civils de Lyon; Faculté de Médecine Lyon Est, 69002 Lyon, France.
¹³ Service d'Urologie et Chirurgie de la Transplantation, Hospices Civils de Lyon; Faculté de Médecine Lyon Est, 69002 Lyon, France.

PMID: 35963778
DOI: 10.1016/j.diii.2022.07.002

Abstract

Purpose: The purpose of this multicenter study was to evaluate the clinical success at three months of prostate artery embolization (PAE), assess PAE safety in centers with various experiences and identify factors associated with PAE success.

Patients and methods: This multicenter, retrospective study included patients who underwent PAE for lower urinary tract symptoms (LUTS) including those with indwelling urinary catheter. PAE clinical success was defined as either 25% improvement of the International Prostate Symptom Score (IPSS) or 1-point improvement of quality of life (QoL) score, or catheter removal at three months. Multivariable analyses were performed using a logistic regression adjusted on patient variables, technical parameters and center experience in PAE.

Results: A total of 383 men (mean age, 68.4 ± 9.7 [standard deviation] years; range: 46-94) with LUTS, including 99 (25.8%) patients with indwelling urinary catheter, were included in seven centers from January 2017 to March 2019. Five patients reported major complications (1.3%), three (0.8%) penile ulceration, three (0.8%) acute urinary retention, one (0.3%) prostatic abscess, and 56 (14.6%) minor complications. Follow up data were available for 271 patients (center 1: n = 159; other centers: n = 112). Clinical success was reported in 232 patients (85.6%). In multivariable analyses, presence of cardiovascular comorbidities (diabetes, stroke history, myocardial infarction and lower limb artery disease) was the single independent variable inversely associated with PAE clinical success (odds ratio = 0.396; 95% confidence interval: 0.17-0.91; P = 0.029). There was no center effect.

Conclusion: Our results show that PAE is safe and effective in centers with various PAE experiences. Cardiovascular comorbidity is the single independent variable associated with PAE failure.

Keywords: Benign prostatic hyperplasia; Lower urinary tract symptoms; Predictive factors; Prostatic artery embolization.

Publication types

Multicenter Study

MeSH terms

Aged
Arteries
Catheters, Indwelling
Humans
Lower Urinary Tract Symptoms* / etiology
Lower Urinary Tract Symptoms* / therapy
Male
Middle Aged
Prostate
Quality of Life
Retrospective Studies
Urinary Catheterization
Urinary Catheters*