Transurethral Prostate Resection (TURP) vs. Prostate Artery Embolization (PAE)

Transurethral Prostate Resection (TURP) vs. Prostate Artery Embolization (PAE): Open Multicentric Randomized Study for Evaluation of Outcomes, Complications, and Health Economics

Centrallasarettet Västerås, Lasarettet i Enköping, Sormland County Council, Sweden, Helsingborgs Hospital

This study focuses on the treatment of benign prostatic hyperplasia which causes lower urinary tract symptoms. The purpose of the research project is to evaluate PAE in terms of both medical and health economic outcomes. To evaluate whether there are any differences in effect (IPSS), complications, costs and perceived quality of life compared with TUR-P.

Prostate Artery Embolization (PAE) is performed by experienced interventional radiologists. The method involves catheterization of the prostate vessels superselectively with two to three French microcatheters. PAE is performed with microspheres of 250 to 400 µm in size.

Under general/regional anesthesia, a resectoscope is inserted into the urethra that carries an electric metal loop (monopolar or bipolar diathermy) that is used to cut and extract the prostate tissue.

Assess the change in the lower urinary tract symptoms using the International Prostate Symptom Score (IPSS) questionnaire before and after prostate artery embolization procedure (PAE) compared to transurethral resection of the prostate (TURP)

Assess the health care costs after prostate artery embolization procedure (PAE) compared to transurethral resection of the prostate (TURP)

Assess the adverse effects after prostate artery embolization procedure (PAE) compared to transurethral resection of the prostate (TURP)

Assess the quality of life after prostate artery embolization procedure (PAE) compared to transurethral resection of the prostate (TURP). Scored 0-100, where 0 is the lowest and 100 the highest possible quality of life.

Erectile function using the International Index of Erectile Function (IIEF-5). The possible scores for the IIEF-5 range from 5 to 25, and ED is classified into five categories based on the scores: severe (5-7), moderate (8-11), mild to moderate (12-16), mild (17-21), and no ED (22-25).

Inclusion Criteria: Benign prostatic hyperplasia where medical treatment has not helped or for other reasons has not been deemed applicable IPSS>=8 Prostate volume [40-80] ml measured via transrectal ultrasound Peak flow rate (Qmax) <= 15 ml / s, Verified obstruction by urodynamic studies (cystometry) Surgery not contraindicated Exclusion Criteria: Prostate cancer Severe atherosclerosis Kidney failure Urethral stricture Active cystitis or prostatitis Bladder stone. Neurogenic bladder disorder Contrast product allergy

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