Does protective coiling of penile collaterals during Prostatic artery embolization (PAE) impact erectile function? A propensity-matched analysis

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Submission ID :
GEST2021-24
Submission Topic
Sub-topics
Prostate Artery Embolization (PAE)
Purpose :
Prostatic artery embolization (PAE) has been proposed as a good option for benign prostatic hyperplasia (BPH) patients who wish to maintain sexual function. Vascular penile anastomoses are an intra-procedural dilemma, and it is unclear if protectively coiling these vessels could negatively impact erectile function. We investigated the impact of coil protection on erectile function.
Materials & Methods :
Retrospective analysis of a prospective multicentre PAE study (UK-ROPE study) identified all BPH patients with International Index of Erectile Function (IIEF-15) scores at baseline and within 12 months post-procedure. A propensity-matched analysis (matched for age, baseline IIEF and the use of 5-alpha-reductase inhibitors with logistic regression/nearest neighbour) and paired t-test were used to compare the change in IIEF between those that had penile collateral coiling against a matched group that did not.
Results :
26/216 patients enrolled in the UK-ROPE study underwent coil protection of an accessory pudendal/ penile collateral. After exclusions, 22 propensity-matched pairs were identified. Mean IIEF at baseline for the coiled group was 14.8 +/-8.3 (out of possible 30) and 14 +/- 7.8 for the non-coiled group. At 12-months follow-up post-procedure, the mean follow-up IIEF score was 15.5 +/- 8.0 for the coiled group and 14.2 +/-8.2 for the non-coiled group. The difference in IIEF post embolization was not significantly different between the two groups (0.66+/-3.8 vs 0.20 +/- 2.0, p=0.64; CI -1.53-2.44).
Conclusions :
Protective coil embolization of penile collaterals/accessory pudendal vessels during PAE is unlikely to negatively impact erectile function.
Clinical Lecturer
,
University of Southampton
University Hospital Southampton
University Hospital Southampton
University Hospital Coventry & Warwickshire
University Hospital Southampton
University Hospital Southampton
University Hospital Southampton

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