Purpose: Several classes of medications are used for lower urinary tract symptoms (LUTS) associated with benign prostatic hypertrophy (BPH). The purpose of this study is to analyze changes in medication use after prostate artery embolization (PAE) performed for LUTS.
Material and Methods: Retrospective review was performed of 31 patients undergoing PAE in a metropolitan health system from 6/2/2014-6/17/19. Inclusion criteria: LUTS secondary to BPH), no prior prostate interventions, and bilateral PAE. Exclusion criteria: PAE for hematuria. Medication status and dosages were recorded before PAE and 6 months post-PAE for alpha-blockers (AB), 5-alpha reductase inhibitors (5ARi), and phosphodiesterase-5 inhibitors (PDE5i). Paired t-test and chi-square analyses were performed.
Results: 24 patients had baseline mean±SD IPSS 22.0±9.40, and QoL 4.63±1.25. At first follow-up mean±SD IPSS 6.67±6.51, mean decrease 15.33 (95% confidence interval [CI] 11.07-19.60, p<0.0001); mean±SD QoL 1.38±1.49, mean difference 3.25 (95% confidence interval [CI] 2.50-4.00, p<0.0001). Pre-PAE medications used included: AB 21 (87.5%), 5ARi 11 (45.8%), AB+5ARi 10 (41.7%), and PDE5i 2 (8.3%). The rate of each medication cessation post-PAE was the following: AB 8 (33.3%, p=0.089), 5ARi 3 (12.5%, p=0.001). 3 (9.7%) patients stopped 2 medications. 7 (22.6%) patients completely stopped their medications post-PAE.
Conclusions: Individuals taking 5ARi experienced a statistically significant decrease in their use at 6 months post-PAE in addition to a decrease in IPSS and QOL scores.