JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 71

Abstracts
Methods: 46 patients (mean age 74 years) with BPH
treated with PAE in a single institution were analysed retrospectively (mean follow-up 18 months). All patients
were evaluated by digital rectal examination, prostatespecific antigen, transrectal ultrasound (TRUS) and computed-tomography angiogram. PAE was performed using
300-500μm embospheres, under local anaesthesia by unilateral/bilateral femoral approach. Clinical follow-up
included post-void residual volume (PVR), prostatic volume (PV) using TRUS, International Prostate Symptom
Score (IPSS), quality of life (QoL) and peak urinary flow
(Qmax) recorded at 1, 3, 6 and 12 months.
Results: Urinary retention (63.3%) and lower urinary
tract symptoms (36.7%) were the most common indications for PAE. 72% of patients were catheter-free at 1
month and 67% had complete resolution of symptoms at
6 months. Bilateral PAE was performed in 83.3% of cases.
The mean PVR (pre-PAE vs post-PAE 410.4ml vs 131ml;
p<0.05), mean PV (144.0ml vs 80.2ml, with a mean reduction of 44.3%; p<0.05), mean IPSS (13.0 vs 5.3; p<0.05),
mean QoL (5.5 vs 1.3; p<0.05) and mean Qmax (7.8ml/s vs
12.9ml/s; p<0.05) were significantly different with respect
to baseline. There were no major complications reported.
Conclusions: PAE is an effective and minimally-invasive
alternative for the treatment of BPH, which should be
considered in medically refractory BPH and in patients
who are not candidates for transurethral resection of the
prostate or prostatectomy.
P8-4 Prostatic arterial embolisation:
outcomes at a UK tertiary referral centre
Johnstone C1, Kumar P1, Ravi R1, Lucky M1, Baird A1
1Aintree University Teaching Hospital, Liverpool, United Kingdom

Introduction: Innovation in surgery and the need for
less invasive therapeutic options with reduced side
effects have driven the advent of minimally invasive procedures for the treatment of benign prostatic hyperplasia
(BPH). Prostatic Arterial Embolisation (PAE) has been
proven to reduce prostatic volume resulting in symptomatic improvement.
Patients and Methods: We report findings from a prospective study of PAE outcomes from May 2015 to
December 2017 at a UK tertiary centre. Follow up IPSS
score was compared using a T-Test.
Results: 27 patients (mean age 64yrs) were analysed.
Main indication was minimal invasiveness and preservation
of erectile function. 25 (92%) had received maximal medical therapy. Mean IPSS and QOL scores pre-procedure
were 23 and 4. Average Qmax was 9mls/s and mean postvoid residual urine volume was 135mls. 3 patients had long
term catheters. 10 patients had urodynamically proven
obstruction. 24 (89%) had bilateral PAE (3 unilateral).

71
Follow up MRI at 3 months showed a mean volume reduction of 18% (96mls to 79mls). There have been no significant reported complications. At follow-up 70% of patients
reported improvement in symptoms with a mean IPSS
score 11, representing a 52% reduction (P < 0.001). A 50%
improvement (mean 2) in QOL was also reported.
Conclusions: PAE is a safe and minimally invasive option
for the treatment of BPH. 18% volume reduction is seen at
3 months on MRI. During follow up 70% of patients have
reported symptom improvement with a mean reduction
of 12 points (52%) in IPSS score compared to pre-procedure scores.
P8-5 Day case TURP in a stand-alone unit
with no beds - is this feasible? Prospective
review of the first 100 cases
Blach O1, Teixeira H1, Peacock J1, Woodhams S1
Hospital, United Kingdom

1Worthing

Introduction: Inpatient TURP remains the gold standard
operation for BPH but advances in novel procedures
increasingly allow for same day discharges. We have
reviewed our new day-case TURis service in a stand-alone
unit with no inpatient capacity.
Patients and Methods: 100 consecutive patients under
the care of a single consultant were prospectively reviewed.
Standard Trust policy for day-case surgery and <80cc
prostates were intended selection criteria. Larger prostates were partially resected (middle and 1 lateral lobe).
Outpatient TWOCs were performed following surgery.
Results: 53 patients underwent TURis for LUTS, 46 for
retention (41 with pre-op catheter) and 2 for haematuria.
Of the 63 patients who had measured prostate volumes,
17 had >80cc.
Average resection time was 38min (range 5-90min), with
resected volume of 17.2g (range 1-40g). Button diathermy/
ablation electrode was used in addition to the loop in 11
cases.
Only 1 patient (1%) required post-op ambulance transfer
to the main hospital due to haematuria and was discharged
after overnight observation.
Within the first 30 days 4 patients were readmitted: 1 with
urosepsis, 1 with acute retention post-TWOC, and 2 with
haematuria, of which 1 required RBC transfusion following
secondary haemorrhage (1%). 18 patients attended A&E
during that time: 17 with catheter-related issues and 1
with LUTS post-TWOC.
Average time to post-TURis TWOC was 5.8 days. 96
patients passed first TWOC, with 99 catheter-free at 30
days.
Conclusions: Day-case TURIS can be delivered safely and
effectively in a stand-alone unit with very low rates of
admission.



Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018

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