Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates
| Autor: | F. Barbosa, Sardis Honoria Harward, Antonio Rampoldi, Silvia Secco, Aldo Massimo Bocciardi, Francisco Cesar Carnevale, Vercelli Ruggero, M. Solcia, C. Migliorisi, Dario Di Trapani, Giovanni Prestini, Antonio Galfano, P.M. Brambillasca |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty 030232 urology & nephrology Urology Prostatic Hyperplasia urologic and male genital diseases 030218 nuclear medicine & medical imaging Catheterization Cohort Studies 03 medical and health sciences 0302 clinical medicine Lower Urinary Tract Symptoms Prostate Lower urinary tract symptoms Artery embolization medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Aged Aged 80 and over business.industry Bladder catheterization Hyperplasia Middle Aged medicine.disease Embolization Therapeutic Prostatic artery embolization Discontinuation medicine.anatomical_structure Treatment Outcome Quality of Life Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular and interventional radiology. 40(4) |
| ISSN: | 1432-086X |
| Popis: | To prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates.Patients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters.A total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome.PAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options. |
| Databáze: | OpenAIRE |
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