Mp46-09 Second Line Therapy After Failed Prostate Artery Embolisation (Pae)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III (MP46)1 May 2024MP46-09 SECOND LINE THERAPY AFTER FAILED PROSTATE ARTERY EMBOLISATION (PAE) Khaled Alghueiri, Philipp Engert, Mohamed Alhabib, Stephan Weinknecht, Armin Soave, and Martin Friedrich Khaled AlghueiriKhaled Alghueiri , Philipp EngertPhilipp Engert , Mohamed AlhabibMohamed Alhabib , Stephan WeinknechtStephan Weinknecht , Armin SoaveArmin Soave , and Martin FriedrichMartin Friedrich View All Author Informationhttps://doi.org/10.1097/01.JU.0001008668.53858.38.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: to analyze factors that predict failure of PAE and to evaluate the second intervention and its outcomes. METHODS: We analysed 344 patients undergoing PAE at our institution between Jan. 2017 and Jan. 2022 in a retrospective, monocentric, questionnaire-based study. Minimum follow up time was 12 months, with a median follow-up of 37 months. The questionnaire included information on complications, satisfaction, second intervention, histology and IPSS. RESULTS: We analyzed the data of 156 out of 344 patients who consented to participate in the study. The mean age was 66 years, median PSA was 3,7 ng/ml, median prostate volume was 70 ml [54, 91], the median IPSS score was 27. The median post-void residual volume (PVR) was 50ml. The median change in the IPSS after the first PAE was 8 points. Preoperative, 5 patients had an indwelling urinary catheter, from them, 4 (80%) had a second intervention after the PAE.We found a significant correlation (p<0.05) between PAE failure and higher patient age, preoperative urinary retention, and smaller prostate volume. In total, 44 patients (28.2%) have either undergone or are scheduled for a second intervention. Among the 35 patients who underwent a second operation, 13 patients (37.1%) had a holmium laser enucleation of the prostate (HOLEP), 11 patients (31.4%) had a transurethral resection of the prostate (TURP), 4 patients (11.4%) had a second PAE, 3 patients (8.6%) had a Rezūm, 3 patients (8.6%) had a simple open Prostatectomy, and 1 patient (2.9%) underwent Aquablation 5 from 27 (18.5%) patients who underwent a histological evaluation had an incidental prostate cancer (iPCa), 4 had a Gleason score of 3+3 and 1 had a Gleason score of 4+3. In Figure 1, we analyzed the IPSS score after the second operation. The findings revealed that both HOLEP and TURP demonstrated a significant improvement in the IPSS (p<0.05). CONCLUSIONS: PAE has a significant failure rate, about 30% of patients underwent a second intervention after PAE. Ablative interventions are more effective as a second-line therapy compared to non-ablative options. Limited data suggests that Aquablation can lead to a reduction of 30 points in IPSS and it's worth noting that a second PAE may be a potential option.Additionally, the incidence rate of iPCa after BPH surgery in our study was 18%, which aligns with rates observed in other studies. Download PPT Source of Funding: No source of Funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e756 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Khaled Alghueiri More articles by this author Philipp Engert More articles by this author Mohamed Alhabib More articles by this author Stephan Weinknecht More articles by this author Armin Soave More articles by this author Martin Friedrich More articles by this author Expand All Advertisement PDF downloadLoading ...