Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia

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 cm³ (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.