Prostatic artery embolization associated with increased rate of readmission among BPH patients

A new study conducted by Brendan Raizenne and team it was shown that even when individual patient comorbidities and surgical volume were taken into account among BPH patients, prostatic artery embolization (PAE) in a real-world population was linked to the highest 30-day and 90-day readmission rates to inpatient or emergency rooms as well as the highest retreatment rate of all surgical methods.

The findings of this study were published in the World Journal of Urology.

The use of minimally invasive surgical techniques (MISTs) to treat lower urinary tract problems brought on by benign prostatic hyperplasia (BPH) is rising in popularity. Prostatic artery embolization reduces the size of prostatic arteries by selectively angioembolizing them, which helps with LUTS/BPH. However, there is a dearth of real-world data comparing the surgical results of MISTs with tissue resective procedures. Therefore, in a real-world sample of patients with LUTS/BPH, researchers evaluated the differences in surgical outcomes between PAE, transurethral resection of the prostate (TURP), and prostatic urethral lift (PUL).

12,902 BPH-afflicted males in New York State who had PAE, TURP, and PUL in outpatient and ambulatory surgical settings from 2014 to 2018 were the subjects of an observational population-based research. In order to assess short-term outcomes between groups, researchers used 2 tests and mixed-effect logistic regressions to present 30-day and 90-day chances of readmission to inpatient and emergency room (ER) with/without problems. Using Kaplan-Meier failure curves for long-term outcomes, we reported surgical retreatment and stricture rates and evaluated them using Log rank tests and Cox regression models.

The key findings of this study were:

There were 12 902 males, 335 of whom had PAE, 11,205 TURP, and 1362 PUL. Patients with PAE had the greatest rates of readmission to inpatient or ER at 30 days (19.9%) and 90 days (35.6%) (p 0.01). 

The primary diagnosis linked to readmissions to inpatient or ER at 30 and 90 days following PAE (14.3% and 26.8%, respectively) was non-specific stomach discomfort. In comparison to TURP and PUL, PAE patients saw the greatest retreatment rate (28.5%) after two years of follow-up.

In conclusion, when individual patient comorbidities and surgical volume were taken into account, PAE demonstrated the highest likelihood of 30-day and 90-day readmission to inpatient or ER as well as the highest retreatment rate of all surgical methods in a real-world population.

Reference: 

Raizenne, B. L., Zheng, X., Oumedjbeur, K., Mao, J., Zorn, K. C., Elterman, D., Bhojani, N., McClure, T., Te, A., Kaplan, S., Sedrakyan, A., & Chughtai, B. (2022). Prostatic artery embolization compared to transurethral resection of the prostate and prostatic urethral lift: a real-world population-based study. In World Journal of Urology. Springer Science and Business Media LLC. https://doi.org/10.1007/s00345-022-04218-6