📃 Paper Title: Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study)
🧍 Author: Alistair F Ray
🕒 Year: 2018
📚 Journal: BJU International
🌎 Country: United Kingdom
ㅤContext to the study:
Can you tell me about a study that compared the safety and efficacy of prostate artery embolization?
ㅤ✅ Take-home message of study:
In patients presenting BPH with LUTS:
PAE was efficacious, but not non-inferior to TURP in International Prostate Symptom Score (IPSS) improvement.
PAE offered a reduced length of hospital stay compared to TURP (0 v 2 days) and faster return to usual activities (5 v 14 days).
Reported complications for both procedures were minor (Clavien-Dindo 1-2).
ㅤ Prospective longitudinal cohort study with propensity score matched analysis.
ㅤ
Study participants:
Inclusion criteria:
Men with LUTS who had consented to undergo PAE or TURP (in 19 UK-ROPE centers).
Men able to read, write and understand English and give informed written consent.
Number included: 305 (216 PAE, 89 TURP) consecutive men included in the cohort, 65 propensity score matched pairs for the comparative analysis.
At baseline PAE patients had a larger prostate volume (101 v 66 mls) but similar symptom scores.
ㅤ
ㅤ
Key study outcomes:
Follow-up was for 12 months.
Primary outcome: Improvement in the International Prostate Symptom Score (IPSS) >3 points between baseline and 12 months for patients undergoing PAE -> outcome met with mean IPSS improvement 10 points at 12 months.
Secondary outcome: Improvement in IPSS non-inferior to TURP at 12 months (< 3 points difference) -> outcome not met. Median IPSS improvement 10 v 15 points from baseline for PAE v TURP, respectively.
Complications after PAE (Clavien-Dindo grade): I grade (n=9); II grade (n=2)
Rate of reintervention after PAE: 5% at 12 months, and another 15% beyond 12 months.
ㅤ
ㅤ
Study Limitations:
Non-randomised comparison.
Non-response rate of patients to the questionnaires.
ㅤ