Prostatic Artery Embolization as a Primary Treatment for Benign Prostatic Hyperplasia: Preliminary Results in Two Patients

Journal Article · Thu Apr 15 00:00:00 EDT 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9727-Z· OSTI ID:21429022

Antunes, Alberto Azoubel ^[1]; Baroni, Ronaldo Hueb ^[2]; Marcelino, Antonio Sergio Zafred ^[3]; Freire, Geraldo Campos ^[1]; Moreira, Airton Mota ^[4]; Srougi, Miguel ^[1]; Cerri, Giovanni Guido ^[5]

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1. University of Sao Paulo Medical School, Urology Department, Hospital das Clinicas (Brazil)
2. University of Sao Paulo Medical School, Magnetic Resonance Unit, Radiology Institute, Hospital das Clinicas (Brazil)
3. University of Sao Paulo Medical School, Ultrasound Unit, Radiology Institute, Hospital das Clinicas (Brazil)
4. University of Sao Paulo Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil)
5. University of Sao Paulo Medical School, Radiology Department, Radiology Institute, Hospital das Clinicas (Brazil)

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency. Various medications, specifically 5-{alpha}-reductase inhibitors and selective {alpha}-blockers, can decrease the severity of the symptoms secondary to BPH, but prostatectomy is still considered to be the traditional method of management. We report the preliminary results for two patients with acute urinary retention due to BPH, successfully treated by prostate artery embolization (PAE). The patients were investigated using the International Prostate Symptom Score, by digital rectal examination, urodynamic testing, prostate biopsy, transrectal ultrasound (US), and magnetic resonance imaging (MRI). Uroflowmetry and postvoid residual urine volume complemented the investigation at 30, 90, and 180 days after PAE. The procedure was performed under local anesthesia; embolization of the prostate arteries was performed with a microcatheter and 300- to 500-{mu}m microspheres using complete stasis as the end point. One patient was subjected to bilateral PAE and the other to unilateral PAE; they urinated spontaneously after removal of the urethral catheter, 15 and 10 days after the procedure, respectively. At 6-month follow-up, US and MRI revealed a prostate reduction of 39.7% and 47.8%, respectively, for the bilateral PAE and 25.5 and 27.8%, respectively, for the patient submitted to unilateral PAE. The early results, at 6-month follow-up, for the two patients with BPH show a promising potential alternative for treatment with PAE.

• OSTI ID: 21429022
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 33, Issue 2; Conference: CIRSE 2010: Congress of th Cardiovascular and Interventional Radiological Society of Europe, Valencia (Spain), 2-6 Oct 2010; Other Information: DOI: 10.1007/s00270-009-9727-z; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BIOPSY
EMBOLI
NMR IMAGING
PROSTATE
RECTUM
ULTRASONOGRAPHY
URINE
BIOLOGICAL MATERIALS
BIOLOGICAL WASTES
BLOOD VESSELS
BODY
BODY FLUIDS
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
GASTROINTESTINAL TRACT
GLANDS
INTESTINES
LARGE INTESTINE
MALE GENITALS
MATERIALS
ORGANS
WASTES