Abstract
2114 A PROSPECTIVE ANALYSIS OF PROSTATIC ARTERY EMBOLIZATION AS A PRIMARY TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA: A PILOT STUDY
The Journal of urology, Vol.185(4S), pp.e845-e846
04/2011
DOI: 10.1016/j.juro.2011.02.2310
Abstract
INTRODUCTION AND OBJECTIVES
Benign prostatic hyperplasia (BPH) is the most common benign neoplasm in men. It has been estimated that the prevalence of lower urinary tract symptom (LUTS) ranges from 8% of men in their 30s to 88% of men older than 80 years. Minimally invasive techniques have been developed as alternatives of treatment for BPH. These therapies are less effective compared with transurethral resection of the prostate (TURP) but require only conscious sedation and have fewer side effects. The aim of this is to present the initial results of prostatic artery embolization (PAE) as a primary treatment for BPH in patients with acute urinary retention refractory to medical treatment.
METHODS
A pilot study was conducted with ten patients with acute urinary retention due to BPH who had been managed by indwelling urethral catheters and were waiting for TURP. All patients had been treated previously with alpha-blockers without success. Before intervention, the patients underwent physical examination, prostate specific antigen measurement, transrectal ultrasound (US) and magnetic resonance imaging (MRI). Patients with malignancy and any other cause of voiding dysfunction that could be correlated to the urinary obstruction were excluded.
RESULTS
Eleven PAE were performed in ten patients with mean age of 68.4 years (59 to 78). Technical success (bilateral PAE) was 73% (8/11 procedures) and clinical success (catheter removal and symptoms improvement) was 90% (9/10 patients). Three patients with unilateral PAE had clinical success. One patient was embolized bilaterally twice and did not have his catheter withdrawn after procedures. Patients urinated spontaneously from 4–25 days (mean, 12.8) after catheter removal. Most frequent side effects were mild pain (perineal 45.5%, retropubic 27.3% and urethral 18.2%) and diarrhea (18.2%) but no opiate medication was necessary. No major complication was observed. Minimum rectal bleeding was observed in 3/11 (27.3%) and hematuria in 1/11 (9.1%) procedures. US and MRI at 1-month (9 patients), 3-month (7 patients), 6-month (4 patients) and 18-month (2 patients) follow-up showed mean prostate reduction of 27.8% and 25.8%; 33.5% and 29.5%; 30% and 31.2%; 29.6% and 32.9%, respectively. At 3-month follow-up, the mean and median IPSS were 2.9 and 2, respectively (ranged, 1 to 8) and the mean quality of life (QUOL) was 0.7.
CONCLUSIONS
BPH can be safely treated by PAE with low side effects rates and can reduce prostate volume by more than 30%. However, a larger study with more data supporting PAE is necessary to validate our observations.
Details
- Title: Subtitle
- 2114 A PROSPECTIVE ANALYSIS OF PROSTATIC ARTERY EMBOLIZATION AS A PRIMARY TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA: A PILOT STUDY
- Creators
- Joaquim Maurício da Motta-Leal-Filho - São Paulo, BrazilAlberto A. Antunes - Sao Paulo, BrazilFrancisco Cesar Carnevale - São Paulo, BrazilLuciana Mendes de Oliveira Cerri - São Paulo, BrazilRonaldo Hueb Baroni - São Paulo, BrazilAntônio Sérgio Zafred Marcelino - São Paulo, BrazilGeraldo Campos Freire - São Paulo, BrazilGiovanni Guido Cerri - São Paulo, BrazilMiguel Srougi - São Paulo, Brazil
- Resource Type
- Abstract
- Publication Details
- The Journal of urology, Vol.185(4S), pp.e845-e846
- Publisher
- ELSEVIER SCIENCE INC
- DOI
- 10.1016/j.juro.2011.02.2310
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 04/2011
- Academic Unit
- Radiology
- Record Identifier
- 9984700440302771
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