One-year outcomes of glue prostate-artery-embolization for symptomatic benign prostatic hyperplasia: a single-center retrospective cohort study.

Abstract

To assess 12-month outcomes of prostate artery embolization (PAE) using N-butyl cyanoacrylate (NBCA) glue in patients with incapacitating lower-urinary-tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Retrospective single-center observational study of patients evaluated 12 months after PAE done in 2018-2023 using methacryloxysulfolane-NBCA mixed with ethiodized oil. Glue injection was under free- or blocked-flow conditions, depending on artery size and real-time assessment of penetration. Both distal embolization and proximal prostatic-artery occlusion were achieved without filling of collaterals. The 12-month outcomes were the International Prostate Symptom Score (IPSS) and associated Quality-of-Life score (IPSS-QoL), prostate volume, International Index of Erectile Function form 5 (IIEF5), and prostate-specific antigen (PSA) level. A total of 186 patients with a mean age of 67.5 ± 6.0 years were included. All procedures were technically successful. Minor adverse events occurred in 35/186 (18.8%) patients. There were no major complications. At 12 months, significant improvements vs baseline were noted for the IPSS (10 ± 6.6 vs 20.1 ± 6.4, p = 0.0001), IPSS-QoL (2.2 ± 1.6 vs 5.1 ± 0.9, p = 0.0001), and prostate volume (81.1 ± 47.0 mL vs 118.1 ± 67.4 mL, p = 0.0001). The IIEF5 and PSA levels were not significantly different at 12 months vs baseline (16.2 ± 7.2 vs 15.8 ± 6.9, p = 0.814; and 4.9 ± 3.3 vs 4.8 ± 4.2, p = 0.286; respectively). Our data support the feasibility, safety, and sustained effectiveness at 12 months of PAE with NBCA to treat BPH-related LUTS. Question NBCA glue may have advantages over other agents for prostatic artery embolization in BPH, but data on long-term outcomes are scarce. Findings Prostatic artery embolization using glue led to significant decreases in the International Prostate Symptoms Score, quality of life score, and prostate volume at 12-month follow-up. Clinical relevance NBCA glue for prostatic artery embolization in patients with symptomatic BPH is safe and provides sustained symptom relief for at least one year.