Two-year Outcomes after Transurethral Prostate Resection Post-prostatic Artery Embolization Versus Transurethral Prostate Resection Alone For Giant Benign Prostatic Hyperplasia

To compare the long-term (two-year) efficacy between transurethral resection of the prostate (TURP) after prostatic artery embolization (PAE) and TURP only for patients with giant (>100 mL) benign prostatic hyperplasia.

We retrospectively analyzed data from 61 and 150 patients with giant benign prostatic hyperplasia treated with PAE+TURP or TURP alone, respectively, from January 2015 to March 2020. We compared index changes before and after surgery.

The operative time, intraoperative blood loss, postoperative bladder irrigation time, and catheter retention time in the PAE+TURP group were lower than those of the TURP group, while the speed of resection of the lesion and hospitalization costs were more significant (P < 0.05). International prostate symptom score (IPSS), quality of life (QoL), prostate volume, maximum urinary flow rate, detrusor pressure of maximum urinary flow rate, prostate-specific antigen, and urodynamic obstruction were better in the PAE+TURP group than the TURP group at 24 months (P < 0.05). Regarding IPSS and QoL scores at 24 months postoperatively compared with the preoperative period, the PAE+TURP group was better than the TURP group in terms of the storage period, voiding period, and QoL (P < 0.05). The distribution of postoperative adverse event severity classes was comparable between the groups (P = 0.984).

In contrast to TURP alone, PAE + TURP is more expensive but provides better postoperative outcomes; there is no significant difference in terms of the severity grade distribution of postoperative complications.