Superselective prostatic artery embolization in the treatment of large benign prostatic hyperplasia.
| Autor: | Neymark AI; Department of Urology and Nephrology, Altai State Medical University (Federal State Budgetary Educational Institution of Higher Education), Barnaul, Russia., Karpenko AA; E. Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk, Russia., Neymark BA; Department of Urology and Nephrology, Altai State Medical University (Federal State Budgetary Educational Institution of Higher Education), Barnaul, Russia., Tachalov MA; Department of Urology and Nephrology, Altai State Medical University (Federal State Budgetary Educational Institution of Higher Education), Barnaul, Russia., Arzamastsev DD; Department of Urology and Nephrology, Altai State Medical University (Federal State Budgetary Educational Institution of Higher Education), Barnaul, Russia., Torbik DV; Department of Urology and Nephrology, Altai State Medical University (Federal State Budgetary Educational Institution of Higher Education), Barnaul, Russia., Gameeva EV; Federal State Budgetary Institution National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia., Bobrov BY; Yusupovs Hospital, Moscow, Russia., Spivak LG; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Korolev DO; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Tsarichenko DG; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Rapoport LM; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Urologia [Urologia] 2021 Nov; Vol. 88 (4), pp. 374-381. Date of Electronic Publication: 2021 Feb 07. |
| DOI: | 10.1177/0391560321993598 |
| Abstrakt: | Purpose: To evaluate the use of prostatic artery embolization (PAE) as a treatment option for patients with symptomatic benign prostatic hyperplasia (BPH) with prostate volumes of 80 cc and more. Materials and Methods: The study included 75 patients with high anesthesia-related risks for conventional surgery (TURP). All patients were surveyed for symptom burden, using IPSS and quality of life score. The prostate volume was determined by transrectal ultrasonography (TRUS). At baseline, prostate-specific antigen (PSA) level was obtained in all patients. Urodynamics was evaluated using uroflowmetry. Clinical outcomes were assessed at follow-up 1, 3, 6, 12, and 24 months after PAE. Results: The prostate volume decreased significantly at months 1 and 3 post-treatment; the prostate continued shrinking until month 12, and the size was then stabilized. At month 24, prostate volume decreased by 40.82%, from 134.0 ± 8.3 mL at baseline to 79.3 ± 6.6 mL. Postvoid residual (PVR) urine volume was significantly decreased from 55.9 ± 5.3 mL to 22.0 ± 1.8 mL 1 month after PAE ( p < 0.001). Qmax increased from 9.2 ± 0.3 mL/s to 15.7 ± 0.4 mL/s. IPSS score following PAE decreased from 28.2 ± 0.7 to 9.7 ± 0.8 ( p < 0.001). QoL improvement was observed from 4.8 ± 0.2 at baseline to 1.8 ± 0.2 at month 24 ( p < 0.001). Decreased activity and density of adenomatous tissue resulted in decreased total PSA levels: from 5.9 ± 1.1 ng/mL to 2.6 ± 0.2 ng/mL ( p < 0.001). TURP became feasible in 35 patients due to reduction of prostate volumes below 80 mL after PAE. Conclusions: PAE was effective in relieving LUTS and reducing prostate size, and may be considered as a preoperative approach for patients with large prostate. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|