Impact of Repeat Prostate Artery Embolization on Sexual Function

Wednesday, March 8, 2023

3:27 PM – 3:36 PM

Location: Phoenix Convention Center, 226ABC

Presenting Author(s)

Piyush Goyal, n/a (he/him/his)

Medical Student
Northwestern University Feinberg School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

KJ

Kimberly Jenkins, n/a

Patient Care Coordinator
Northwestern Memorial Hospital
EH

Elias Hohlastos, MD

Professor
Northwestern University Feinberg School of Medicine
Riad Salem, MD

Professor
Northwestern Memorial Hospital
SM

Samdeep Mouli, MD

Attending
Northwestern University Feinberg School of Medicin

Disclosure(s):

Piyush Goyal, n/a: No financial relationships to disclose

Samdeep Mouli, MD: Boston Scientific Corporation: Research Grant Recipient (Ongoing)

Purpose:

Prostate artery embolization (PAE) is an effective treatment option for lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) {1}. Furthermore, repeat PAE for refractory LUTS has also been shown to be safe, and effective as assessed by International Prostate Symptom Score (IPSS) and Quality of Life (QOL) questionnaires {2}. Many patients seek PAE to avoid the adverse sexual side-effects of surgery or other minimally invasive surgical techniques (MISTs). However, the impact of repeat PAE on sexual function is not known. The purpose of this study was to report the International Index of Erectile Function (IIEF-EF) and Male Sexual Health Questionnaire (MSHQ) outcomes of patients who underwent repeat PAE for refractory LUTS.

Materials and Methods:

This was a single-center IRB-approved retrospective study. All PAE cases between January 2015 and September 2022 were queried to identify all patients who had >1 PAEs performed at the same institution by the same operator. PAE was performed using standard techniques, with 300-500 micron particles used for embolization in all cases. Patients were followed at 1, 3, 6 and 12 months after each PAE, and any adverse events (AE) in accordance with SIR guidelines were noted. IPSS, QoL, IIEF-EF, MSHQ-EjD and MSHQ-Bother scores were recorded at each follow-up.

Results:

A total of 24 patients who underwent two or more PAEs were identified. Mean patient age was 63.9±8.8 years. Mean duration between initial and repeat PAE was 2.0±1.7 years. Successful embolization to stasis was achieved in all cases, and there were no major or minor AEs. Improvements in IPSS, QoL, IIEF-EF, MSHQ-EjD and MSHQ-Bother scores at last follow up are reported in Table 1 for both initial PAE and repeat PAE.

Conclusion:

Repeat PAE was shown to be effective in managing refractory LUTS, as it significantly reduced IPSS and QoL scores. Furthermore, repeat PAE had no significant impact on erectile and ejaculatory function as assessed by IIEF and MSHQ scores. Therefore, patients may consider repeat PAE for management of LUTS, particularly if they prioritize maintenance of sexual function.