eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank


4/2017
vol. 12
 
Share:
Share:
more
 
 
abstract:
Original paper

Clinical evaluation of embolization of the superior vesical prostatic artery for treatment of benign prostatic hyperplasia: a single-center retrospective study

Zhilei Qiu, Changcun Zhang, Xinsheng Wang, Kai Cheng, Xin Liang, Dawen Wang, Sichuan Hou

Videosurgery Miniinv 2017; 12 (4): 409–416
Online publish date: 2017/12/29
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction: Non-surgical minimally invasive treatments are greatly needed for patients with symptomatic benign prostatic hyperplasia (BPH), for whom medical treatment has failed and surgery is contraindicated. This study retrospectively evaluated the efficacy and safety of super-selective prostatic artery embolization (PAE) for BPH, relative to transurethral resection of the prostate (TURP).

Aim: To clinically evaluate the efficacy and safety of super-selective PAE for BPH, relative to TURP.

Material and methods: From February 2012 to March 2015, patients with BPH underwent selective PAE (n = 17) or TURP (control group; n = 40). Prostate volume, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS), and quality of life (QoL) score were evaluated at baseline and postoperative 3, 6, and 12 months. Complications were also recorded.

Results: All the procedures were technically successfully. At postoperative 1 year, patients given PAE had significantly greater prostate volume (64.6 ±10.2 ml), IPSS (23.9 ±4.9), and QoL (4.1 ±0.7) compared with the control patients (42.0 ±7.5 ml, 13.1 ±3.5, and 2.1 ±0.7, respectively). The Qmax of the PAE group (9.5 ±3.7 ml/s) was significantly lower than that of the control (21.8 ±4.2 ml/s). The changes in parameters of the TURP patients relative to the preoperative baseline were significantly greater than those of the PAE group. No severe complications occurred.

Conclusions: Prostatic artery embolization was demonstrated as safe and effective and may be considered an alternative treatment for BPH patients, especially for those who are not candidates for or refuse surgery.

keywords:

lower urinary tract symptoms, benign prostatic hyperplasia, transurethral resection of the prostate, super-selective prostatic artery embolization

references:
Thorpe A, Neal D. Benign prostatic hyperplasia. Lancet 2003; 361: 1359-67.
Oelke M, Bachmann A, Descazeaud A, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 2013; 64: 118-40.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011; 185: 1793-803.
Pinheiro LC, Martins Pisco J. Treatment of benign prostatic hyperplasia. Tech Vasc Interv Radiol 2012; 15: 256-60.
Reich O, Gratzke C, Bachmann A, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 2008; 180: 246-9.
Favilla V, Cimino S, Salamone C, et al. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): a 12 months follow-up. J Endocrinol Invest 2013; 36: 1094-8.
Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP): incidence, management, and prevention. Eur Urol 2006; 50: 969-79.
Denmeade SR, Egerdie B, Steinhoff G, et al. Phase 1 and 2 studies demonstrate the safety and efficacy of intraprostatic injection of PRX302 for the targeted treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Eur Urol 2011; 59: 747-54.
Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ 2008; 337: a1662.
Mitchell ME, Waltman AC, Athanasoulis CA, et al. Control of massive prostatic bleeding with angiographic techniques. J Urol 1976; 115: 692-5.
Michel F, Dubruille T, Cercueil JP, et al. Arterial embolization for massive hematuria following transurethral prostatectomy. J Urol 2002; 168: 2550-1.
DeMeritt JS, Elmasri FF, Esposito MP, et al. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after trans­arterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol 2000; 11: 767-70.
de Assis AM, Moreira AM, de Paula Rodrigues VC, et al. Prostatic artery embolization for treatment of benign prostatic hyperplasia in patients with prostates > 90 g: a prospective single-center study. J Vasc Interv Radiol 2015; 26: 87-93.
Pisco JM, Pinheiro LC, Bilhim T, et al. Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol 2011; 22: 11-9.
Wang MQ, Guo LP, Zhang GD, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population. BMC Urol 2015; 15: 33.
Gao YA, Huang Y, Zhang R, et al. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate: a prospective, randomized, and controlled clinical trial. Radiology 2014; 270: 920-8.
Barry MJ, Fowler FJ Jr, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992; 148: 1549-57.
Carnevale FC, Antunes AA, Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it. Cardiovasc Intervent Radiol 2013; 36: 1452-63.
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA, et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol 2013; 24: 535-42.
Rio Tinto H, Martins Pisco J, Bilhim T, et al. Prostatic artery embolization in the treatment of benign prostatic hyperplasia: short and medium follow-up. Tech Vasc Interv Radiol 2012; 15: 290-3.
Baazeem A, Elhilali MM. Surgical management of benign prostatic hyperplasia: current evidence. Nat Clin Pract Urol 2008; 5: 540-9.
Bilhim T, Pisco J, Rio Tinto H, et al. Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement. Cardiovasc Intervent Radiol 2013; 36: 403-11.
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA, et al. Midterm follow-up after prostate embolization in two patients with benign prostatic hyperplasia. Cardiovasc Intervent Radiol 2011; 34: 1330-3.
Sun F, Sánchez FM, Crisóstomo V, et al. Transarterial prostatic embolization: initial experience in a canine model. AJR Am J Roentgenol 2011; 197: 495-501.
Sun F, Sánchez FM, Crisóstomo V, et al. Benign prostatic hyperplasia: transcatheter arterial embolization as potential treatment: preliminary study in pigs. Radiology 2008; 246: 783-9.
Bilhim T, Tinto HR, Fernandes L, et al. Radiological anatomy of prostatic arteries. Tech Vasc Interv Radiol 2012; 15: 276-85.
Schreuder SM, Scholtens AE, Reekers JA, et al. The role of prostatic arterial embolization in patients with benign prostatic hyperplasia: a systematic review. Cardiovasc Intervent Radiol 2014; 37: 1198-219.
Bilhim T, Pisco JM, Rio Tinto H, et al. Prostatic arterial supply: anatomic and imaging findings relevant for selective arterial embolization. J Vasc Interv Radiol 2012; 23: 1403-15.
Verret V, Ghegediban SH, Wassef M, et al. The arterial distribution of Embozene and Embosphere microspheres in sheep kidney and uterus embolization models. J Vasc Interv Radiol 2011; 22: 220-8.
  
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe