N-butyl cyanoacrylate glue application in prostate artery embolization for benign prostatic hyperplasia: a systematic review of safety and efficacy
Abstract
Benign prostatic hyperplasia (BPH) is the most common urological disorder in older males, often treated with prostate artery embolization (PAE) to alleviate lower urinary tract symptoms. While traditional embolic materials like microspheres are common, issues such as symptom recurrence and non-target embolization remain. This systematic review evaluates the safety and effectiveness of n-butyl cyanoacrylate (NBCA) glue as an alternative embolic agent for PAE. A thorough search was performed across databases including PubMed, ScienceDirect, Cochrane, Google Scholar, Scopus, and MEDLINE. Studies were included if they assessed NBCA glue for PAE in BPH patients. Exclusions were made for reviews, non-English articles, conference abstracts, and studies not using glue or ethiodized oil mixtures. The Methodological Index for Non-Randomized Studies criteria was used to assess bias risk, and due to varied outcome measures, a narrative synthesis was conducted. Six studies involving 667 patients met the inclusion criteria. The age in mean ± SD across studies ranged from 67.5 ± 7.8 to 72.6 ± 10.5 with most patients presenting with moderate to severe BPH unresponsive to medication. NBCA glue-based procedures showed high technical success rates and shorter procedure times. International Prostate Symptom Score improvement was reported in 83–94% of patients across all studies with associated quality of life significantly enhanced in up to 94% of patients as well. Prostate volume reduction…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 667 participants or records.
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