This study leverages pre-procedural data and machine learning (ML) techniques to predict outcomes at one year following prostate artery embolization (PAE). This retrospective analysis combines data from the UK-ROPE registry and patients that underwent PAE at our institution between 2012 and 2023. Traditional ML approaches, including linear regression, lasso regression, ridge regression, decision trees and random forests, were used with leave-one-out cross-validation to predict international prostate symptom score (IPSS) at baseline and change at 1 year. Predictors included age, prostate volume, Qmax (maximum urinary flow rate), post-void residual volume, Abrams-Griffiths number (urodynamics score) and baseline IPSS (for change at 1 year). We also independently confirmed our findings using a separate dataset. An interactive digital user interface was developed to facilitate real-time outcome prediction. Complete data were available in 128 patients (66.7 ± 6.9 years). All models predicting IPSS demonstrated reasonable performance, with mean absolute error ranging between 4.9–7.3 for baseline IPSS and 5.2–8.2 for change in IPSS. These numbers represent the differences between the patient-reported and model-predicted IPSS scores. Interestingly, the model error in predicting baseline IPSS (based on objective measures alone) significantly correlated with the change in IPSS at 1-year post-PAE (R2 = 0.2, p < 0.001), forming the basis for our digital user interface. This study uses ML methods to predict IPSS improvement at 1 year, integrated into a user-friendly interface for real-time prediction. This tool could be used to counsel patients prior to treatment.

Purpose: To explore whether coil embolization of penile collateral arteries to prevent nontarget embolization during Materials and Methods: Retrospective analysis was performed on a prospectively maintained multicenter PAE database on all patients with benign prostatic hyperplasia (January 2014 to July 2016). International Index of Erectile Function (IIEF-5) scores were collected at baseline and within 12 months after the procedure. A logistic regression and nearest neighbor propensity-matched analysis (matched for age, baseline IIEF-5 scores, and use of 5 alpha-reductase inhibitors) and paired t test were used to evaluate for differential impact on IIEF-5 scores between the group of patients who underwent (unilateral) penile collateral coil embolization and a matched control group of patients who did not. Results: Of a total of 216 patients, 26 underwent coil protection of an accessory pudendal vessel/penile collateral. After exclusions, 22 propensity-matched pairs were identified. The mean IIEF-5 score at baseline for the coil-embolized group was 14.8 +/- 8.3 (out of a possible score of 30) and that for the matched control group was 14.0 +/- 7.8. At the 12-month followup after the procedure, the mean follow-up IIEF-5 score was 15.5 & PLUSMN; 8.0 for the coil-embolized group and 14.2 +/- 8.2 for the matched control group. The change in IIEF-5 scores after PAE was not significantly different between the 2 groups (0.66 +/- 3.8 vs 0.20 +/- 2.0; P = .64; 95% CI, -1.53 to 2.44). Conclusions: When penile collateral arteries were identified, protective coil embolization of penile collateral/accessory pudendal vessels during PAE was unlikely to affect erectile function negatively.

Purpose Prostate artery embolisation (PAE) is a key treatment for the management of symptomatic benign prostatic hyperplasia (BPH). Common cardiovascular risk factors might be associated with suboptimal outcomes and thus influence patient treatment selection. The aim of the study was to evaluate whether cardiovascular comorbidities affect PAE outcomes. Methods Retrospective subset analysis of the UK Registry of Prostate Artery Embolisation (UK-ROPE) database was performed with patients who had a full documented past medical histories including hypertension, diabetes, coronary artery disease (CAD), diabetes and smoking status as well as international prostate symptom score (IPSS) at baseline and at 12 months. Multiple regression was performed to assess for any significant predictors. Results Comorbidity data were available for 100/216 patients (mean age 65.8 ± 6.4 years), baseline IPSS 20.9 ± 7.0). Regression analysis revealed that the presence of hypertension (53.7% IPSS reduction vs. absence 51.4%, p = 0.94), diabetes (52.6% vs. absence 52.1%, p = 0.6), CAD (59.2% vs. absence 51.4%, p = 0.95), no comorbidities (49.8% vs. any comorbidity present 55.3%, p = 0.66), smoking status (non-smoker, 52.6%, current smoker, 61.5%, ex-smoker, 49.8%, p > 0.05), age ( p = 0.52) and baseline Qmax ( p = 0.41) did not significantly impact IPSS reduction at 12 months post-PAE. Baseline prostate volume significantly influenced IPSS reduction (≥ 80 cc prostates, 58.9% vs. < 80 cc prostates 43.2%, p < 0.05). Conclusion The presence of cardiovascular comorbidities/smoking history does not appear to significantly impact PAE symptom score outcomes at 12 months post procedure. Our findings suggest that if the prostatic artery can be accessed, then clinical success is comparable to those without cardiovascular comorbidities. Graphical Abstract

Introduction Paediatric varicocele embolization has many benefits over surgical ligation, but lacks published long-term data. We investigated technical and clinical outcomes in this under reported patient group. Objective To evaluate technical success, complications and recurrence rates following varicocele embolization in paediatric patients. Materials and methods A single-centre retrospective review of procedural data and electronic notes of consecutive patients referred for varicocele embolization over a 10-year period was performed (February 2010-March 2020). The primary outcomes were technical success and clinical efficacy (lack of symptom recurrence). Secondary outcomes included complications, testicular vein size reduction and procedural parameters including radiation exposure. Chi-square analysis was used to identify predictors of clinical success. Follow-up involved outpatient clinical assessment and telephone interview. Results 40 patients (median age 15) were referred for leftsided symptomatic varicocele. Technical embolization success was achieved in 36/40 patients (90%), with 4 procedures abandoned (inaccessible vein). Embolization technique was platinum-based coils +/- sclerosant. There were no immediate or long-term procedural complications. 32/36 patients completed short term follow-up at a median interval of 2.8 months. 30/32 (93.78%) experienced early clinical success. We found a significant reduction in peritesticular vein size following embolization (pre-3.70 vs post-2.56 mm, p = 0.00017) and a significant relationship between varicocele grade and early clinical success (chi 2 = 4.2, p = 0.04), but not pre-treatment peritesticular vein size (chi 2 = 0.02, p = 0.88). 33/36 patients completed long-term follow-up (median 4.2 years, range 0.36-9.9 years) producing a late clinical success rate of 93.9% (31/33). No post procedural complications including hydroceles were identified. Discussion This study demonstrates technical success, matching rates described in adult patients which is reassuring and in support of embolization in the younger patient cohort. More importantly, the overall clinical success rate is comparable with previous embolization studies. Reassuringly, all symptom recurrences occurred early in follow-up, and there is a cogent argument for a single follow-up appointment at this juncture. Our long-term average follow-up duration, primarily gained via telephone interview, exceeds other studies. Although our study has the longest follow-up for varicocele embolization in children, it is limited by a few patients being lost to early and long-term follow-up. This is a recognised issue faced by studies attempting to follow-up benign conditions with a high clinical success rate. Conclusion Paediatric varicocele embolization is a successful alternative to surgical ligation, with no complications and good clinical outcomes over a long-term follow-up.

AIM: To evaluate the effectiveness of a novel, resorbable, spherical embolic agent compared with other established agents, by studying percentage fibroid infarction (the best indicator of long-term symptom improvement) in patients undergoing uterine fibroid embolisation (UFE). MATERIALS AND METHODS: This retrospective cohort study examined six different embolic agents used for fibroid embolisation, including a new gelatin-based, fully resorbable, spherical agent. The primary effectiveness outcomes were magnetic resonance imaging (MRI)-determined dominant fibroid infarct percentage (DF%) and all fibroid percentage infarct (AF%) at 3 months post-embolisation. MRI-determined uterine artery patency rate was the secondary outcome. Chi-squared test (chi(2)), relative risk (RR) calculation (primary outcomes), and analysis of variance (ANOVA) (secondary outcome) were the statistical tests employed. RESULTS: One hundred and twenty patients were treated with six embolic agents (20 consecutive patients per group, overall mean age 44.8 +/- 6.4, initial uterine volume 570 +/- 472 ml, dominant fibroid volume 249+324 ml). Fibroid infarctrates were similar between the cohorts with no significant difference between the new gelatin-based resorbable particle and other embolics in either DF% (chi(2)=3.92, p=0.56) or AF% (chi(2)=2.83, p=0.73). Complete DF% RR=1.07 (0.90-1.27) and AF% RR=1.09 (0.85-1.41) suggest non-inferiority of the resorbable particle (d=0.67, p<0.05). A favourable uterine artery patency rate was demonstrated for the resorbable particle compared with gelatin slurry (82.5% versus 27.5%, p<0.001 after Bonferroni adjustment). CONCLUSIONS: This new gelatin-based, fully resorbable particle is an effective embolic agent for fibroid embolisation and achieves an infarct rate non-inferior to established embolics. (C) 2021 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.

Objective To determine whether prostate artery embolization (PAE) is a cost-effective alternative to transurethral resection of the prostate (TURP) in the management of benign prostate hyperplasia (BPH) after 1-year follow-up. Design, setting and main outcome measures A retrospective cost-utility analysis over a 12-month time period was conducted to compare the two interventions from a National Health Service perspective. Effectiveness was measured as quality-adjusted life years (QALYs) derived from data collected during the observational UK Register of Prostate Embolisation (UK-ROPE) Study. Costs for both PAE and TURP were derived from University Hospital Southampton, a tertiary referral centre for BPH and the largest contributor to the UK-ROPE. An incremental cost-effectiveness ratio (ICER) was derived from cost and QALY values associated with both interventions to assess the cost-effectiveness of PAE versus TURP. Further sensitivity analyses involved a decision tree model to account for the impact of patient-reported complications on the cost-effectiveness of the interventions. Results The mean patient age for TURP (n=31) and PAE (n=133) was 69 and 65.6 years, respectively. In comparison to TURP, PAE was cheaper due to shorter patient stays and the lack of necessity for an operating theatre. Analysis revealed an ICER of £64 798.10 saved per QALY lost when comparing PAE to TURP after 1-year follow-up. Conclusion Our findings suggest that PAE is initially a cost-effective alternative to TURP for the management of BPH after 1-year follow-up. Due to a higher reintervention rate in the PAE group, this benefit may be lost in subsequent years. Trial registration number NCT02434575.

Purpose To compare the relative IPSS (International Prostate Symptom Score) improvement in storage and voiding symptoms between prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP). Method Retrospective analysis of the UK-ROPE (UK Register of Prostate Embolization) multicentre database was conducted with inclusion of all patients with full IPSS questionnaire score data. The voiding and storage subscore improvement was compared between interventions. Student's t-test (paired and unpaired) and ANOVA (Analysis of variance) were used to identify significant differences between the groups. Results 146 patients (121 PAE, 25 TURP) were included in the analysis. Storage symptoms were more frequently the most severe symptom (`storage' in 75 patients vs `voiding' in 17 patients). Between groups, no significant difference was seen in raw storage subscore improvement (TURP 4.9 vs PAE 4.2; p = 0.34) or voiding subscore improvement (TURP 8.4 vs PAE 6.7; p = 0.1). ANOVA demonstrated a greater proportionate reduction (relative to total IPSS) towards voiding symptoms in the TURP group (27.3% TURP vs 9.9% PAE, p = 0.001). Conclusion Although both TURP and PAE improve voiding symptoms more than storage, a significantly larger proportion of total symptom reduction is due to voiding in the TURP cohort, with PAE providing a more balanced improvement between voiding and storage.

The effect of Uterine Fibroid Embolization on fertility and ovarian reserve remains uncertain. We assessed the impact of a new resorbable, spherical particle (Gelbead) on concentration of Anti-Mullerian (AMH) hormone, fibroid volume and uterine artery patency. This prospective cohort study recruited consecutive patients from July 2017 to June 2018. Serum AMH, fibroid and uterine volume, UFS-QOL (uterine fibroid score-quality of life) scores were measured prior to and at 1 month and/or 3 months post embolization. Twenty-four participants were enrolled (median age 44 years, uterine volume 484 cm3, initial dominant fibroid volume 167 cm3). One patient was lost to follow-up. AMH (median ± SD) immediately prior to embolization was 3.2 ± 13.7 pmol/L. At 1-month postembolization, AMH was 4.1 ± 8.6 pmol/L and at 3 months 4.4 ± 8.6 pmol/L. We found no significant difference in AMH levels between baseline and at 1 month (p = 0.58) or baseline and 3 months (p = 0.17). The median dominant uterine fibroid volume decreased (167 to 64 cm3, p < 0.001). At 3 months post-embolization, 17/23 patients had patent uterine arteries bilaterally (73.9%). UFE with Gel-bead did not significantly affect AMH at 3 months post embolization, whilst maintaining a high rate of uterine artery patency.

© Author(s) (or their employer(s)) 2021. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. ABSTRACT Objective To determine whether prostate artery embolization (PAE) is a costeffective alternative to transurethral resection of the prostate (TURP) in the management of benign prostate hyperplasia (BPH) after 1year followup. Design, setting and main outcome measures A retrospective costutility analysis over a 12month time period was conducted to compare the two interventions from a National Health Service perspective. Effectiveness was measured as qualityadjusted life years (QALYs) derived from data collected during the observational UK Register of Prostate Embolisation (UKROPE) Study. Costs for both PAE and TURP were derived from University Hospital Southampton, a tertiary referral centre for BPH and the largest contributor to the UKROPE. An incremental costeffectiveness ratio (ICER) was derived from cost and QALY values associated with both interventions to assess the costeffectiveness of PAE versus TURP. Further sensitivity analyses involved a decision tree model to account for the impact of patientreported complications on the costeffectiveness of the interventions. Results The mean patient age for TURP (n=31) and PAE (n=133) was 69 and 65.6 years, respectively. In comparison to TURP, PAE was cheaper due to shorter patient stays and the lack of necessity for an operating theatre. Analysis revealed an ICER of £64 798.10 saved per QALY lost when comparing PAE to TURP after 1year followup. Conclusion Our findings suggest that PAE is initially a costeffective alternative to TURP for the management of BPH after 1year followup. Due to a higher reintervention rate in the PAE group, this benefit may be lost in subsequent years. Trial registration number NCT02434575.

Introduction Optisphere (Teleflex, Wayne, PA, USA, currently distributed by Medtronic, Minneapolis, MN, USA) is a new, resorbable, calibrated spherical embolic agent. We aimed to evaluate its clinical safety and effectiveness for fibroid embolization through a prospective case series. Method This prospective case series studied patients treated with fibroid embolization using Optisphere between July 2017 and June 2018. The primary outcomes were device-related adverse event assessments and MRI-determined percentage infarct of the dominant fibroid (DF %) and infarct of all fibroids (AF %) at 3 months post-embolization. Secondary outcomes included symptom improvement with the validated Uterine Fibroid Symptom Score and Quality of Life questionnaire (UFS-SS and UFS-QOL) at 3 months and 12 months post-embolization. Statistical analysis was through the Wilcoxon signed-rank test for nonparametric paired data. Results Twenty-three consecutive patients were treated with Optisphere (median age 44.0, uterine volume 484.0 ml, dominant fibroid volume 167.0 ml). The complete dominant fibroid infarction (DF %) rate was 91.3% (21/23 patients), and the complete all fibroid infarction rate (AF %) was 82.6% (19/23). No adverse device-related safety events were encountered. Significant improvement was demonstrated in 3-month UFS-SS (56 vs 19, p < 0.0001), UFS-QOL (40 vs 88, p = 0.0008), uterine volume (484 ml vs 246 ml, p < 0.0001) and dominant fibroid volume (167 vs 64 ml, p < 0.0001). Symptomatic improvement continued to 12 months (UFS-SS 56 vs 11, p = 0.0008, UFS-QOL 40 vs 98.7, p = 0.0008). Conclusion Optisphere is an effective embolic agent for fibroid embolization with good symptomatic response and percentage fibroid infarct.

Few studies on prostate artery embolization (PAE) follow patients up after 12 months. We aimed to evaluate the symptomatic efficacy of PAE in our patient cohort at 3 years. A total of 48 consecutive patients undergoing PAE from June 2012 to August 2014 were included in this retrospective study. All patients underwent formal urodynamics to confirm bladder outflow obstruction prior to PAE. International Prostate Symptom Score (IPSS) was performed at baseline, 3 months, 12 months and 3 years post-PAE. Mean patient age was 65.6 ± 7.4, prostate volume 99.1 ± 56.6 cm3, IPSS 23.5 ± 6.0, quality-of-life score 4.6 ± 0.9, Qmax 8.4 ± 2.8 ml/s, post-void residual volume 185.8 ± 55.6 ml. Technical success (bilateral embolization) was achieved in 43 out of 48 cases (89.6%). 11/39 bilateral PAE patients completing follow-up (2 died, 2 lost to follow-up) underwent surgery, indicating a 71.8% clinical success rate at 3 years. No significant change was demonstrated in IPSS or QOL between 1 and 3 years for patients free from surgical intervention (IPSS 8.3 vs 10.0, p = 0.09 and QOL 1.3 vs 1.5, p = 0.23). 3/11 patients undergoing surgery had a prominent ‘ball-valve’ median lobe, and 1/11 patients had a high bladder neck elevation contributing to symptoms. Clinical success post-PAE remains high with few patients opting for surgery or experiencing a worsening of symptoms after 12 months.

INTRODUCTION:The UK Registry of Prostate Artery Embolization (UK-ROPE) was a prospective, multicentre study comparing PAE against surgical therapies for symptomatic benign prostatic hyperplasia (BPH). A wealth of data was collected supplementary to the main study outcomes which provide a snapshot of UK PAE practice. We aimed to interpret these data in the hope of providing insight into factors which affect clinical outcome and radiation dose. METHODS:216 patients (mean age 66, mean IPSS 21.3) undergoing PAE at 20 British centres from July 2014 to January 2016 were prospectively followed up to 12 months with retrospective analysis of the data. Technical outcome was evaluated based on procedural and fluoroscopy times, skin dose and dose area product (DAP). Clinical outcome was evaluated through collection of Qmax, IPSS reduction and prostate volume reduction. Multiple analysis of variance (MANOVA) was used to assess the significance of various patients and procedural factors on clinical outcome and patient dose. RESULTS:Significant predictors of technical outcome which affected patient skin dose included severity of CTA-detected atheroma (p < 0.001), the practitioner (p < 0.001) and use of protective coil embolization (p = 0.019). Predictors of clinical outcome included initial prostate size (dichotomized into groups > 80 ml and = <80 ml, d = 1, p = 0.0138), embolic agent (spherical particles < 300 nm performed best, p = 0.01) and number of arteries embolized (IPSS reduction of 32.9% in unilateral PAE versus 54.4% for bilateral PAE, p = 0.026). CONCLUSION:We have identified several important factors which are associated with improved clinical outcome and increased patient dose which we hope will facilitate optimal patient selection and encourage improved embolization technique.

Patency of the uterine arteries after embolization may have important implications for women with future fertility wishes. We aimed to investigate if certain embolic agents achieved a greater patency rate whilst not compromising on infarct achieved. A prospective study of 124 patients undergoing uterine fibroid embolization (UFE) at a single centre was conducted. Multivariate analysis was performed to compare the uterine artery patency rates of six different embolic agents; PVA, Embozene, Beadblock, Embosphere, Gelfoam, Optisphere. The ANOVA multivariate analysis adjusted for factors including operator, dominant fibroid volume, uterine volume, patient age. Bonferri statistical adjustment was performed. Ordinal regression analysis was conducted to assess for differences in fibroid infarct percentage (classified as 100% infarct, 90-99% and <90%). Baseline patient characteristics were similar to previous studies (mean age 44.8, Uterine volume 579.8 cm3, dominant fibroid volume 249.0 cm3) with no significant difference between the embolic groups. Optisphere (adjusted marginal mean uterine artery patency 83.9%), Embosphere (68.3%) embozene (94.5%), beadblock (91.8%), and PVA (88.9%) all demonstrated similar levels of artery patency following multivariate analysis with no statistically significant difference between these embolic agents (p=1.0 after Bonferri adjustment). Optisphere demonstrated a greater level of vessel patency compared with Gelfoam 83.9% vs 14.0% (mean difference 69.9, p=0.001). All embolic agents demonstrated similar levels of dominant fibroid (DF) and all fibroid (AF) infarct (Optisphere vs other particles; DF odds ratio 0.28- 1.3 p=0.19-0.81, AF odds ratio 0.18-2.0 p=0.23-0.67). Most embolic agents achieved similar levels of uterine artery patency after embolization, other than Gelfoam which had a higher rate of uterine artery occlusion.

Many studies have looked at global changes in the International Prostate Symptom Score (IPSS) following PAE; however, no studies have examined the breakdown between storage and voiding symptoms. We aimed to explore the extent to which PAE improves storage symptoms in relation to voiding symptoms. This single-center, prospective cohort study recruited consecutive patients undergoing PAE from June 2012 to June 2016. The IPSS breakdown was recorded pre-PAE, at 3 months and 12 months post-PAE. Planned statistical analysis included the paired t test. A total of 43 patients were recruited (mean age 64.72 ± 6.27, prostate volume 88.65 ± 37.23 cm3, IPSS 23.02 ± 5.84, QoL 4.98 ± 1.01, PSA 4.2 ± 2.8). Storage symptoms were more frequently the most severe symptom (58.1%). Voiding score (13.35–5.39, p < 0.001) and storage score (9.67–5.08, p < 0.001) both improved; however, voiding improved to a greater extent (1.9 vs. 1.5 mean per question, p = 0.023). PAE was most consistent when improving storage symptoms (‘Urgency’ improved in 86% patients, ‘Frequency’ and ‘Nocturia’ 77%). Storage symptoms are a significant problem for patients with benign prostatic obstruction. PAE is an effective treatment for both storage and voiding symptoms. More research is needed to evaluate how this compares with surgical techniques.

As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE.

Prostatic artery embolisation can be used to block the blood supply in benign prostatic hypertrophy (BPH), leading to a significant reduction in size and improvement in associated lower urinary tract symptoms. In this article the author describes the results of a recently published multicentre registry study and looks at where this technique can fit in the management of BPH.

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2018MP62-09 PROSTATE ARTERY EMBOLISATION VERSUS TURP; A MULTICENTRIC PROSPECTIVE COMPARISON: THE UK-ROPE STUDY Ranan Dasgupta, Mark Speakman, Alistair Ray, John Powell, Sachin Modi, Grace Carolan-Rees, and Nigel Hacking Ranan DasguptaRanan Dasgupta More articles by this author , Mark SpeakmanMark Speakman More articles by this author , Alistair RayAlistair Ray More articles by this author , John PowellJohn Powell More articles by this author , Sachin ModiSachin Modi More articles by this author , Grace Carolan-ReesGrace Carolan-Rees More articles by this author , and Nigel HackingNigel Hacking More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the emergence of prostate artery embolization (PAE) in treating men with LUTS/BPH), a comparison with the surgical standard of care (transurethral resection of prostate, TURP) has been eagerly sought. With a UK-wide collaboration between the national Urology and Interventional Radiology Societies (BAUS and BSIR), along with the independent body (National Institute for health and Care Excellence; NICE), we present the findings of the UK Registry (UK-ROPE). This offers a multicentre prospective comparative study of PAE versus TURP, to assess the safety and efficacy of PAE, with follow-up to at least 12 months reported, based on questionnaires and quantitative measurements. METHODS Patients identified as suitable for surgical intervention were offered the option of PAE and compared with a matched cohort of patients undergoing TURP at one of the 19 centres recruited. All interventional radiologists were proctored in the same technique, and the surgical team performed their standard endoscopic resection technique. Baseline IPSS questionnaire, uroflowmetry and prostate volume were then repeated at 1, 3, 6 and12 months, through a central independent academic unit (Cedar unit, Cardiff University). The study was powered to detect a difference of 3 units in IPSS score to achieve significance. IPSS improvement at 12 months was the primary outcome. RESULTS A total of 305 cases (216 PAE, 89 TURP) were enrolled. The baseline characteristics were matched, with similar IPSS scores, the PAE group did have significantly larger baseline mean prostate volumes (101g) compared to the TURP group (66g). The table highlights the sustainable improvement in IPSS scores (10 points) and flow parameters for both arms, with no significant difference between types of treatment, although a strong trend towards greater improvements with TURP. An average of 28% reduction in prostate volume was noted in the PAE cohort. CONCLUSIONS This comparative study suggests that PAE can offer significant improvement in urinary symptoms. Its role in the LUTS/BPH treatment armentarium remains to be defined (eg those patients with comorbidity precluding regional or general anaesthesia, and large glands). This is the first large multicentre comparative study attempting to define the efficacy and sustainability of PAE compared to contemporary surgery. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e835 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ranan Dasgupta More articles by this author Mark Speakman More articles by this author Alistair Ray More articles by this author John Powell More articles by this author Sachin Modi More articles by this author Grace Carolan-Rees More articles by this author Nigel Hacking More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...