Purpose To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter–dependent patients with large prostate volumes and high comorbidity scores. Materials and Methods A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48–94 y), age-adjusted Charlson comorbidity index was 4.5 (0–10), duration of urinary retention was 63.4 days (2–224 d), International Prostate Symptom Score quality-of-life (IPSS-QOL) was 5.3 (3–6), and prostate volume was 167.3 cm3 (55–557 cm3). These parameters were collected at 3, 6, and 12 months after PAE. Trials of voiding were performed approximately 2 weeks after PAE and, if failed, every 2 weeks thereafter. Adverse events were graded using the Clavien-Dindo classification. Results At a mean (range) of 18.2 days (1–72 d), 26 (86.7%) patients were no longer reliant on catheters. Follow-up was obtained in all patients eligible at 3 and 6 months and 17 of 20 (85.0%) patients eligible at 1 year. Mean (range) IPSS-QOL improved significantly to 1.2 (0–5), 0.7 (0–4), and 0.6 (0–4) at 3, 6, and 12 months (all P <.001). Mean (range) prostate volume decreased significantly to 115.9 cm3 (27–248 cm3) at 3 months (P <.001). Two patients experienced grade II urosepsis complications, which were successfully treated with intravenous antibiotics. All other complications were self-limited grade I complications. Conclusions PAE represents a safe and effective option for management of patients with urinary retention, especially patients with large prostates who are not ideal surgical candidates.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine