首页良性前列腺增生治疗及预后证据详情

Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia

原文:2016年 发布于 J Vasc Interv Radiol 27卷 第11期 1686-1697.e8 浏览量:592次 原文链接

作者: Uflacker A. Haskal Z. J. Bilhim T. Patrie J. Huber T. Pisco J. M.

作者单位: Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia, 1215 Lee St., Charlottesville, VA 22908. Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia, 1215 Lee St., Charlottesville, VA 22908. Electronic address: haskaljvir@gmail.com. Interventional Radiology Department, Saint Louis Hospital, Lisbon, Portugal. Department of Public Health Sciences, University of Virginia, 1215 Lee St., Charlottesville, VA 22908.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1016/j.jvir.2016.08.004

关键词: *Arteries/diagnostic imaging Embolization Therapeutic Humans Kallikreins/blood Male Prostate/*blood supply Prostate-Specific Antigen/blood Prostatic Hyperplasia/diagnostic imaging/*therapy Quality of Life Time Factors Treatment Outcome

文献简介

PURPOSE: To perform meta-analysis of available data on prostatic artery embolization (PAE). MATERIALS AND METHODS: Meta-analysis was conducted on articles published between November 2009 and December 2015. Peer-reviewed studies with > 5 patients and standard deviations and/or individual-level data on one or more of the following outcomes were included: prostate volume (PV), peak flow rate (Qmax), postvoid residual (PVR), International Prostate Symptom Score (IPSS), quality of life (QOL) score, International Index of Erectile Function (IIEF) score, and prostate-specific antigen (PSA) level. A random-effects meta-analysis was performed on the outcomes at 1, 3, 6, and 12 months after PAE compared with baseline values, with a P < .05 decision rule as the null hypothesis rejection criterion. RESULTS: Nineteen of 268 studies were included in data collection, with 6 included in the meta-analysis. At 12 months, PV decreased by 31.31 cm(3) (P < .001), PSA remained unchanged (P = .248), PVR decreased by 85.54 mL (P < .001), Qmax increased by 5.39 mL/s (P < .001), IPSS improved by 20.39 points (P < .001), QOL score improved by -2.49 points (P < .001), and IIEF was unchanged (P = 1.0). There were a total of 218 adverse events (AEs) among 662 patients (32.93%), with 216 being Society of Interventional Radiology class A/B (99%). The most common complications were rectalgia/dysuria (n = 60; 9.0%) and acute urinary retention (n = 52; 7.8%). No class D/E complications were reported. CONCLUSIONS: PAE provided improvement in Qmax, PVR, IPSS, and QOL endpoints at 12 months, with a low incidence of serious AEs (0.3%), although minor AEs were common (32.93%). There was no adverse effect on erectile function.

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