Evaluation of the super-selective prostate artery embolization combined with TURP for patients with large volume (＞ 80 ml) benign prostatic hyperplasia / 中华泌尿外科杂志

ABSTRACT

Objective To explore the saffety and efficacy of super-selective prostate artery embolization (PAE) combined with TURP (transurethral resection of prostate) as an alternative method for patients with severe large BPH (＞ 80 ml).Methods From March 2015 to June 2017,a total of 40 patients with large benign prostatic hyperplasia who failed in medical treatment were selected for PAE combined with TURP (18 cases)and TURP (22 cases).In the PAE combined with TURP group,the mean age was (75.0±8.7) years (ranging60-88 years) and the mean prostatic volume was (111.0 ±23.3) ml,ranged from 83 to 145 ml).The international prostate symptom score (IPSS),quality of life (QOL),maximal t rine flow rate (Qmax) and postvoid residual urine(PVR) were(25.2 ±3.6),(5.1 ± 1.0),(6.4 ± 2.3) ml/s and (107.7 ± 32.6) ml,respectively.In the TURP group,the mean age was (76.0 ± 6.9) years (ranging 62-85 years) and the mean prostatic volume was (107.5 ±27.4) ml,ranged from 80 to 150 ml).The IPSS,QOL,Q andPVRwere(24.3±4.2),(4.9 ±0.9),(6.7±2.2)ml/s and (106.6±32.2)ml,respectively.Clinical data of all of patients were analyzed retrospectively,including operative time,estimate blood loss,weight and efficacy of resected tissue,time of continuous bladder irrigation and catheterization,IPSS,QOL,PVR,Q and postoperative complications.Results There were significant differences in the operative time [(75.8 ± 25.1) min vs.(103.2 ± 27.7) min],estimate blood loss [(122.8 ± 33.9) ml vs.(447.6 ± 36.0) ml],weight of resected tissue [(99.9 ± 24.2) g vs.(82.9 ± 15.5) g],efficacy of resected tissue [(76.9 ± 20.7) g/h vs.(41.7 ± 14.2) g/h],continuous bladder irrigation time [(1.4 ± 0.5) d vs.(2.4 ± 0.8) d] and catheterization time [(2.2 ± 0.4) d vs.(3.4 ± 0.6) d] between PAE combined TURP group and TURP group (P ＜ 0.05).The postoperative complications of PAE combined TURP group and TURP group were included secondary hemorrhage (0 case vs.3 cases),secondary TURP (0 case vs.3 cases),temporary urinary incontinence (2 case vs.4 case),urinary tract infection (1 case vs.2 case).After 1-year follow up,the IPSS,QOL,Qmax and PVR of PAE combined TURP group and TURP group were (6.7 ±1.5)and(6.9± 1.5),(2.3 ±0.5) and(2.3 ±0.6),(15.6 ±2.3) ml/s and(15.0 ±2.1) ml/s,(32.8±6.5) ml and(32.3± 8.4)ml,respectively.Both goups were found to have significantly improved in IPSS,QOL,Q and PVR,as compared with preoperative indexes,respectively (P ＜ 0.05).However,there was no significant difference in those indexes between two groups (P ＞ O.05).Conclusions PAE combined TURP could be used a safe and effective therapy for treating patients with LUTS due to large volume (＞ 80 ml) BPH.It has been a priority in less blood,more efficient of resected tissue and less postoperative complications.