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Efficacy and safety of prostate artery embolisation for benign prostatic hyperplasia. An observational study and propensity matched comparison with transurethral resection of the prostate (the UK‐ROPE study)

Title: Efficacy and safety of prostate artery embolisation for benign prostatic hyperplasia. An observational study and propensity matched comparison with transurethral resection of the prostate (the UK‐ROPE study)
Authors: Ray, A; Powell, J; Speakman, M; Longford, N; DasGupta, R; Bryant, T; Modi, S; Dyer, J; Harris, M; Carolan-Rees, G; Hacking, N
Publisher Information: Wiley
Publication Year: 2018
Collection: Oxford University Research Archive (ORA)
Description: Objectives The UK Register of Prostate Embolisation (UK ROPE) study aimed to assess the efficacy and safety of Prostate Artery Embolisation (PAE) for Lower Urinary Tract Symptoms secondary to Benign Prostatic Hyperplasia (LUTS/BPH) patients. The main secondary aim was an indirect comparison with transurethral resection of the prostate (TURP). Subjects/patients and methods As a joint initiative between BSIR, BAUS and NICE, this study recruited 305 patients across 17 UK urological / interventional radiology centres: 216 PAE, 89 TURP. The primary outcomes were IPSS improvement in PAE patients at 12 months post-procedure, and complication data post-PAE. We also aimed to compare IPSS score improvements between PAE and TURP, using non-inferiority analysis on propensity-score matched patient pairs. The clinical results and urological measurements were performed at clinical sites. IPSS and other questionnaire-based results were mailed by patients directly to the trial unit managing the study. All data were uploaded centrally to the UK ROPE database. Results PAE is clinically effective, producing a median 10 point IPSS improvement from baseline at 12 months post-procedure. PAE does not appear to be as effective as TURP, which produced a median 15 point IPSS score improvement at 12 months post-procedure. These findings are further supported by propensity score analysis, in which we formed 65 closely matched pairs of PAE and TURP patients. In terms of IPSS and quality of life improvement, there was no evidence of PAE being non-inferior to TURP. PAE patients made a statistically significant improvement in Qmax and prostate volume reduction at 12 months post-procedure. PAE has a reoperation rate of 5% before 12 months and 15% past 12 months (20% total rate), and a low complication rate. Of 216 patients, one had sepsis, one required a blood transfusion, four had local arterial dissection and four had a groin haematoma. Two patients had non-target embolisation that presented as self-limiting penile ulcers. Additional ...
Document Type: article in journal/newspaper
Language: unknown
Relation: https://doi.org/10.1111/bju.14249
DOI: 10.1111/bju.14249
Availability: https://doi.org/10.1111/bju.14249; https://ora.ox.ac.uk/objects/uuid:e582e81a-b80c-4a13-9c58-43d73abf0e18
Rights: info:eu-repo/semantics/openAccess ; CC Attribution-NonCommercial (CC BY-NC)
Accession Number: edsbas.1B4DDAEF
Database: BASE