N-Butyl Cyanoacrylate Glue Versus Nonspherical Polyvinyl Alcohol Particles For Prostatic Arterial Embolization To Treat Benign Prostatic Hyperplasia: Safety and Efficacy
Urology Journal,
Vol. 20 No. 04 (2023),
2 October 2023
,
Page 261-268
https://doi.org/10.22037/uj.v20i.7734
Abstract
Purpose: Our aim is to compare N-butyl cyanoacrylate (NBCA) glue and non-spherical polyvinyl alcohol (PVA)
particles for prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH) to treat lower
urinary tract symptoms (LUTS) and report their feasibility, safety, and short-term effectiveness.
Materials and Methods: 110 patients (mean age: 72.6 years) with BPH related to LUTS were divided into two
groups, PAE was performed in one group with 250 - 355 μm non-spherical PVA particles. Whereas, the other
group received a mixture of NBCA glue/ lipiodol for PAE.
Results: PAE was technically successful in all 110 patients (100 %). During 6 months follow up, we found that
in patients who received NBCA glue, the mean of prostatic volume (PV) was significantly reduced compared to
baseline (67.1 ± 8.5 to 40.2 ± 5.4), International Prostate Symptom Score (IPSS) (25.7 ± 4.3 to 7.2 ± 1.09), Quality
of life (QoL) (4.43 ± 0.27 to 1.58 ± 2.27); whereas, the mean of Peak urinary flow (Qmax) increased significantly
from baseline to 6 months (8.6 ± 2.3 to 15.4 ± 2.3), International Index of Erectile Function (IIEFS) (9.46 ± 1.51 to
19.3 ± 1.33). Meanwhile, non-spherical PVA particles used in the other group show that PV significantly reduced
from baseline to 6 months (68.2 ± 8.32 to 38.8 ± 6.13), IPSS (25.0 ± 3.59 to7.24 ± 0.83), QoL (4.43 ± 0.24 to1.56
± 0.55). The mean for Qmax increased from baseline to 6 months (7.19 ± 1.67 to15.1 ± 2.42), IIEFS (9.22 ± 1.30
to 19.5 ± 0.96).
Conclusion: PAE with NBCA glue and non-spherical PVA particles is feasible, safe, and effective for patients
with BPH related-LUTS. This gives the physicians options to choose between embolizing agents based on the
architecture of the prostatic artery.
- Lower urinary tract symptoms, Benign prostate hyperplasia, Prostate artery embolization, NCBA glue, Non spherical Polyvinyl alcohol
How to Cite
References
Aslan G, Aslan D, Kizilyar A, Ispahi C, Esen A. A prospective analysis of sexual functions during pregnancy. Int J Impot Res. 2005;17:154-7.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793-1803.
Roehrborn CG, Andriole GL, Wilson TH, et al. Patient-reported outcomes after 4 years of treatment with dutasteride plus tamsulosin or either monotherapy in men with benign prostatic hyperplasia. Urology. 2009;73(6):1363-1368.
Madersbacher S, Alivizatos G, Nordling J, Sanz C, Emberton M, de la Rosette J. J. M. C. H. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol. 2004;46(5):547–554.
Oelke M, Bachmann A, Descazeaud A, et al; European Association of Urology. EAU guidelines on the treatment and follow-up of nonneurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2013;64(1):118–140.
Bagla S, Martin CP, Van Breda A, et al. Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia. J Vasc Interv Radiol. 2014;25(1):47–52.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793–1803.
Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomized controlled trials. BMJ. 2008;337(7676):966–969.
Li Q, Duan F, Wang MQ, et al. Prostatic arterial embolization with small-sized particles for the treatment of lower urinary tract symptoms due to large benign prostatic hyperplasia: preliminary results. Chin Med J (Engl). 2015;128:2072-2077.
Gravas S, Cornu JN, Gacci M, Gratzke C, Herrmann TRW, Mamoulakis C, et al. Management of non-neurogenic male LUTS. EAU Guidelines Edn presented at the EAU Annual Congress Amsterdam 2020.
Geevarghese R, Harding J, Parsons N, Hutchinson C, Parsons C. The relationship of embolic particle size to patient outcomes in prostate artery embolization for benign prostatic hyperplasia: A systematic review and meta-regression. Clin Radiol. 2020;75:366–374.
Abdulmalak G, Chevallier O, Falvo N, Di Marco L, Bertaut A, Moulin B, et al. Safety and efficacy of transcatheter embolization with Glubran®2 cyanoacrylate glue for acute arterial bleeding: A single-center experience with 104 patients. Abdom Radiol. 2018;43:723–733.
Loffroy R, Desmyttere AS, Mouillot T, Pellegrinelli J, Facy O, Drouillard A, et al. Ten-year experience with arterial embolization for peptic ulcer bleeding: N-butyl cyanoacrylate glue versus other embolic agents. Eur Radiol. 2021;31:3015–3026.
Dadas B, Alkan S, Cifci M, Basak T. Treatment of tripod fracture of zygomatic bone by n-2-butyl cyanoacrylate glue fixation and its effects on the tissues. Eur Arch Otorhinolaryngol. 2007;264:539–544.
Loffroy R, Mouillot T, Bardou M, Chevallier O. Current role of cyanoacrylate glue transcatheter embolization in the treatment of acute nonvariceal gastrointestinal bleeding. Expert Rev Gastroenterol Hepatol. 2020;14:975–984.
Carnevale FC, Antunes AA, Da Motta JM, Leal Filho et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: Preliminary results in two patients. Cardiovasc Intervent Radiol. 2010;33(2):355–361.
Jeon GS, Won JH, Lee BM, et al. The Effect of Transarterial Prostate Embolization in Hormone-induced Benign Prostatic Hyperplasia in Dogs: A Pilot Study. J Vasc Interv Radiol. 2009;20(3):384–390.
Pisco JM, Rio Tinto H, Campos Pinheiro L, et al. Embolization of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: Results of short- and mid-term follow-up. Eur Radiol. 2013;23(9):2561–2572.
Wang MQ, Guo LP, Zhang GD, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population. BMC Urol. 2015;15:33.
Li YJ, Barthes-Biesel D, Salsac AV. Polymerization kinetics of n-butyl cyanoacrylate glues used for vascular embolization. J Mech Behav Biomed Mater. 2017;69:307–317.
Malling B, Røder MA, Brasso K, Forman J, Taudorf M, Lönn L. Prostate artery embolisation for benign prostatic hyperplasia: A systematic review and meta-analysis. Eur Radiol. 2019;29:287–298.
Shuster A, Gunnarsson T, Klurfan P, Larrazabal R. N-butyl cyanoacrylate proved beneficial to avoid a nontarget embolization of the ophthalmic artery in endovascular management of epistaxis. A neurointerventional report and literature review. Interv Neuroradiol. 2011;17:17–21.
Jae HJ, Chung JW, Kim HC, So YH, Lim HG, Lee W, Kim BK, Park JH. Experimental study on acute ischemic small bowel changes induced by superselective embolization of superior mesenteric artery branches with N-butyl cyanoacrylate. J Vasc Interv Radiol. 2008;19:755–763.
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