The aim of this study was to explore the safety and efficacy of prostatic arterial embolization (PAE) with Bletilla striata particles as embolic agent in treatment of lower urinary tract symptoms (LUTS) resulted from benign prostatic hyperplasia (BPH).
Superselective angiogram of prostatic artery was performed with Seldinger's technique, and the artery was occluded with Bletilla striata particles 150-200 mm. PAE was successful in 68 of 75 patients (90.7%).
The total effective rate in international prostate symptoms score (IPSS), quality of life (QOL), peak urinary flow (Qmax), postvoid residual volume (PVR) at 1, 3, 6, 12 months was 100% (68/68), 100% (68/68), 95.6% (65/68), and 95.6% (65/68), respectively. At 12‑month follow‑up, the mean IPSS, QOL, and PVR decreased from 25.86 ± 3.53 to 6.52 ± 1.51 points (P < 0.01), from 4.56 ± 0.61 to 1.26 ± 0.43 points (P < 0.01), and from 131.52 ± 19.13 to 10.89 ± 2.34 ml (P < 0.01), respectively, while Qmax increased from 9.83 ± 2.14 to 18.15 ± 2.33 ml/s (P < 0.01). The mean prostate volume (PV) decreased from 82.61 ± 23.71 ml to 32.78 ± 3.54 ml (with a mean reduction of 60.31%, P < 0.01). There was no significant difference in prostatic specific antigen (PSA) and international index of erectile function (IIEF) between pre-PAE and post-PAE. One patient had major event of skin necrosis of scrotal and perineal area (1.5%). Recurrence of LUTS was noted in two patients (2.9%).
PAE with Bletilla striata will provide evidence on the effectiveness and safety in treatment of LUTS of BPH. However, more studies are needed to assess the long-term outcomes and potential complications.