Aims and objectives
Lower urinary tract symptoms (LUTS) are one of the most common complaints in elderly men,
and are usually caused by the ongoing growth of prostate tissue with advancing age that leads to compression of the prostatic urethra.
The bladder outlet obstruction secondary to benign prostate hyperplasia (BPH) can impede normal activities and even result in complications such as infections or acute urinary retention.
Management of mild symptoms might benefit from medical therapies such us α-adrenergic blockers or 5-α-reductase,
but many patients experience worsening symptoms despite...
Methods and materials
Patient Selection:
This is a single-center prospective study.
A total of 16 consecutive patients diagnosed with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) were included in the study.
All of the participants were high-risk surgical patients,
did not respond to medical treatment and all but one had an indwelling bladder catheter.
Preprocedural imaging:
All patients underwent pelvic CT angiography before PAE.
The tests were performed with a 64-detector row CT (Aquilion,
Toshiba) or a 8-detector row CT (Brightspeed,
GE Medical...
Results
The 16 patients met the inclusion criteria.
The mean age was 79.37± 4.88 years.
All patients were high-risk surgical candidates: five of them suffered from ischemic cardiomyopathy,
two suffered from Alzheimer’s disease,
one from Parkinson’s disease and six had chronic obstructive pulmonary disease.
Five patients had refused blood transfusion based on religious beliefs and four were treated with oral anticoagulants.
The procedure was technically successful in 13 patients.
PAE was stopped in one patient due to an episode of agitation and only unilateral embolization was...
Conclusion
This single-center prospective study was conducted on high-risk patients refractory to medical therapy.
93.75% of the patients showed a symptomatic improvement and only one patient suffered a procedure-related complication.
Although the size of our sample is limited,
these results suggest that PAE is a safe and effective procedure in severely symptomatic,
BPH patients who are high-risk surgical candidates.
References
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Young S,
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Prostate Arterial Embolization is a Viable Option for Treating Symptoms of Benign Prostatic Hyperplasia.
Journal of Urology.
American Urological Association Education and Research,
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Carnevale FC,
Soares GR,
de Assis AM,
Moreira AM,
Harward SH,
Cerri GG.
Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay.
CardioVascular and Interventional Radiology.
2017 May 15;40(9):1321–37.
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Kuang M,
Vu A,
Athreya S.
A Systematic Review of Prostatic Artery Embolization in the Treatment of Symptomatic Benign Prostatic Hyperplasia.
CardioVascular...