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European Radiology
Erschienen in: European Radiology 7/2021

15.01.2021 | Urogenital

Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials

verfasst von: Peng Xiang, Di Guan, Zhen Du, Yongxiu Hao, Wei Yan, Yonghui Wang, Yutong Liu, Dan Liu, Hao Ping

Erschienen in: European Radiology | Ausgabe 7/2021

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Abstract

Objective

To investigate the efficacy and safety of prostatic artery embolization (PAE) vs. transurethral resection of the prostate (TURP) in patients affected by benign prostatic hyperplasia (BPH). We also reviewed mean changes from baseline in PAE at selected follow-up points.

Methods

PubMed, Web of Science, and Embase were searched up to May 1, 2020. Randomized controlled trials on PAE were collected according to specific inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3, STATA 14, and GraphPad Prism 8. Pooled patient-reported scores and functional outcomes were calculated by using a fixed or random-effect model.

Results

Eleven articles met our selection criteria and ten independent patient series were included in the final analysis. Pooled estimates suggested no significant difference between TURP and PAE for patient-reported outcomes including International Prostate Symptom Score (2.32 (− 0.44 to 5.09)) and quality of life (0.18 (− 0.41 to 0.77)) at 12 months. PAE was less effective regarding improvements in most functional outcomes such as maximum flow rate, prostate volume, and prostate-specific antigen. Moreover, PAE may be associated with relatively fewer complications, lower cost, and shorter hospitalization. After the PAE procedure, the overall weighted mean differences for all outcomes except sexual health scores were significantly improved from baseline during follow-up to 24 months.

Conclusion

PAE is non-inferior to TURP with regard to improving patient-reported outcomes, though most functional parameters undergo more changes after TURP than after PAE. Moreover, PAE can significantly continue to relieve symptoms for 24 months without causing serious complications.

Key Points

• PAE is as effective as TURP in improving subjective symptom scores, with fewer complications and shorter hospitalization times.
• PAE is inferior to TURP in the improvement of most functional outcomes.
• Improvements due to PAE are durable during follow-up to 24 months.
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Metadaten
Titel
Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials
verfasst von
Peng Xiang
Di Guan
Zhen Du
Yongxiu Hao
Wei Yan
Yonghui Wang
Yutong Liu
Dan Liu
Hao Ping
Publikationsdatum
15.01.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 7/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07663-2

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