Abstract No. 284 Comparison of PAE for BPH on Prostate Gland Size <80 g versus >80 g: Retrospective Review of Short-Term to Mid-Term Outcomes in a Single Center

PAE is a minimally invasive procedure for treating LUTS of prostatic origin. This study compares the efficacy and safety outcomes of PAE in baseline prostate volumes < 80 g versus >80 g. 922 patients underwent PAE from April 2014 to August 2022 with gland size estimated by preprocedural MR or ultrasound. Patients were divided into “Group A” (n = 251) with < 80-g prostates and “Group B” (n = 671) with >80-g prostates. Mean age was 70 ± 9 years. Mean prostate volume was 58 ± 14 g in group A and 142 ± 62 g in Group B. Evaluation occurred at 3, 12, 24, 60-month (m) intervals following PAE. Changes in IPSS, QoL, and prostate volume were calculated. Nonresponse was defined as IPSS >13 after PAE. Adverse events were recorded using the Clavien-Dindo (CD) classification. Two-tailed P < 0.05 was considered significant. Median follow up was 1000 days (15-3087). Median baseline IPSS was 25 [IQR 21-29] in Group A and 22 [IQR 17- 27] in Group B (P< 0.01). Median baseline QoL was 5 [IQR 4-6] in Group A and 5 [IQR 4-6] in Group B (P = 0.2). Table compares change in IPSS, QoL, % change in prostate size, and clinical nonresponse percentage after PAE. Although change in IPSS was similar, QoL and prostate size decreased more in group B patients at 3 and 12 m post PAE. A higher percentage of clinical nonresponse was identified in Group A (23%) compared with Group B (11%) early after PAE. 86 patients (34%) in Group A and 232 patient (35%) in Group B had self-limited CD grade 1 postoperative symptoms (frequency, urgency and dysuria) (P = 0.6). 3 (0.3%) had CD grade 4 events, urosepsis and were treated with IV antibiotics. 3 TIAs occurred which resolved without intervention. Patients with larger prostate glands at baseline have more decrease in prostate size and QoL, and lower incidence of persistent symptoms. However, PAE is safe and effective in reducing IPSS and improving QoL in prostate glands >80 g as well as those with glands < 80 g.