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Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization

BACKGROUND: To investigate the influence of benign prostatic hyperplasia (BPH) patterns detected with MRI on clinical outcomes after prostatic artery embolization (PAE). MATERIALS & METHODS: This retrospective study included 71 consecutive patients with lower urinary tract symptoms (LUTS), who u...

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Autores principales: Boschheidgen, Matthias, Al-Monajjed, Rouvier, Minko, Peter, Jannusch, Kai, Ullrich, Tim, Radke, Karl Ludger, Michalski, Rene, Radtke, Jan Philipp, Albers, Peter, Antoch, Gerald, Schimmöller, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978045/
https://www.ncbi.nlm.nih.gov/pubmed/36859572
http://dx.doi.org/10.1186/s42155-023-00357-y
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author Boschheidgen, Matthias
Al-Monajjed, Rouvier
Minko, Peter
Jannusch, Kai
Ullrich, Tim
Radke, Karl Ludger
Michalski, Rene
Radtke, Jan Philipp
Albers, Peter
Antoch, Gerald
Schimmöller, Lars
author_facet Boschheidgen, Matthias
Al-Monajjed, Rouvier
Minko, Peter
Jannusch, Kai
Ullrich, Tim
Radke, Karl Ludger
Michalski, Rene
Radtke, Jan Philipp
Albers, Peter
Antoch, Gerald
Schimmöller, Lars
author_sort Boschheidgen, Matthias
collection PubMed
description BACKGROUND: To investigate the influence of benign prostatic hyperplasia (BPH) patterns detected with MRI on clinical outcomes after prostatic artery embolization (PAE). MATERIALS & METHODS: This retrospective study included 71 consecutive patients with lower urinary tract symptoms (LUTS), who underwent magnetic resonance imaging (MRI) of the prostate followed by PAE at a single centre. MRI scans were evaluated and BPH patterns were determined according to Wasserman type and a modified BPH classification. Additionally, scans were evaluated regarding the presence of adenomatous-dominant benign prostatic hyperplasia (AdBPH). LUTS were assessed using the International Prostate Symptom Score (IPSS) and urinary flow rate (Qmax). Follow-up examination included MRI and clinical outcome. RESULTS: For clinical outcome at follow-up, IPSS showed median reduction of 54% (IQR 41—75%) and Qmax improved by 4.1 ml/s. We noted significant reduction in volume, intraprostatic protrusion, and prostatic urethral angle in our collective (p < 0.01). Median volume reduction was 25% (IQR 15%—34%). Bilateral embolization was a significant predictor for volume reduction at follow-up. Multiple linear regression analysis showed significant effect of high initial volume on reduction in IPSS after treatment (p < 0.01). Presence of AdBPH was significantly associated with both, volume loss and clinical improvement in terms of IPSS reduction (p < 0.01). Neither BPH pattern based on the Wassermann type nor modified BPH classification were significantly related with postinterventional IPSS and volume loss. CONCLUSIONS: Men benefit from PAE regardless the macroscopic BPH MRI pattern. Preinterventional prostate volume and presence of AdBPH on MRI should be considered for outcome prognosis after PAE.
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spelling pubmed-99780452023-03-03 Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization Boschheidgen, Matthias Al-Monajjed, Rouvier Minko, Peter Jannusch, Kai Ullrich, Tim Radke, Karl Ludger Michalski, Rene Radtke, Jan Philipp Albers, Peter Antoch, Gerald Schimmöller, Lars CVIR Endovasc Original Article BACKGROUND: To investigate the influence of benign prostatic hyperplasia (BPH) patterns detected with MRI on clinical outcomes after prostatic artery embolization (PAE). MATERIALS & METHODS: This retrospective study included 71 consecutive patients with lower urinary tract symptoms (LUTS), who underwent magnetic resonance imaging (MRI) of the prostate followed by PAE at a single centre. MRI scans were evaluated and BPH patterns were determined according to Wasserman type and a modified BPH classification. Additionally, scans were evaluated regarding the presence of adenomatous-dominant benign prostatic hyperplasia (AdBPH). LUTS were assessed using the International Prostate Symptom Score (IPSS) and urinary flow rate (Qmax). Follow-up examination included MRI and clinical outcome. RESULTS: For clinical outcome at follow-up, IPSS showed median reduction of 54% (IQR 41—75%) and Qmax improved by 4.1 ml/s. We noted significant reduction in volume, intraprostatic protrusion, and prostatic urethral angle in our collective (p < 0.01). Median volume reduction was 25% (IQR 15%—34%). Bilateral embolization was a significant predictor for volume reduction at follow-up. Multiple linear regression analysis showed significant effect of high initial volume on reduction in IPSS after treatment (p < 0.01). Presence of AdBPH was significantly associated with both, volume loss and clinical improvement in terms of IPSS reduction (p < 0.01). Neither BPH pattern based on the Wassermann type nor modified BPH classification were significantly related with postinterventional IPSS and volume loss. CONCLUSIONS: Men benefit from PAE regardless the macroscopic BPH MRI pattern. Preinterventional prostate volume and presence of AdBPH on MRI should be considered for outcome prognosis after PAE. Springer International Publishing 2023-03-02 /pmc/articles/PMC9978045/ /pubmed/36859572 http://dx.doi.org/10.1186/s42155-023-00357-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Boschheidgen, Matthias
Al-Monajjed, Rouvier
Minko, Peter
Jannusch, Kai
Ullrich, Tim
Radke, Karl Ludger
Michalski, Rene
Radtke, Jan Philipp
Albers, Peter
Antoch, Gerald
Schimmöller, Lars
Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title_full Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title_fullStr Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title_full_unstemmed Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title_short Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
title_sort influence of benign prostatic hyperplasia patterns detected with mri on the clinical outcome after prostatic artery embolization
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978045/
https://www.ncbi.nlm.nih.gov/pubmed/36859572
http://dx.doi.org/10.1186/s42155-023-00357-y
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