Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique

Kably, I.; Pereira, Keith; Chong, W.; Bhatia, Shivank

doi:10.1016/j.urology.2015.10.025

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…PAE resulted in immediate cessation of gross hematuria in all patients, without complication. Three patients with prostatic hematuria related to TURP or traumatic bladder catheter removal were reported in a second case series (73); PAE resolved the hematuria within 24 hours and caused no complications. In a prospective cohort study of 12 patients with BPH-related hematuria (70), cessation of bleeding was achieved by PAE in all patients, with no adverse events.…”

Section: Hematuria Of Prostatic Originmentioning

confidence: 99%

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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BPH ¼ benign prostatic hyperplasia, IIEF ¼ International Index of Erectile Function, IPSS ¼ International Prostate Symptom Score, LUTS ¼ lower urinary tract symptoms, MIST ¼ minimally invasive surgical therapies, OP ¼ open prostatectomy, PAE ¼ prostatic artery embolization, PVR ¼ postvoid residual, QOL ¼ quality of life, RCT ¼ randomized controlled trial, TURP ¼ transurethral resection of the prostate, UK-ROPE ¼ United Kingdom Register of Prostate Embolization BACKGROUND Benign prostatic hyperplasia (BPH) describes the proliferation of the glandular and stromal tissue in the transition zone of the prostate, which may result in bladder outlet obstruction and consequent lower urinary tract symptoms (LUTS). The prevalence of BPH increases with age, affecting more than 70% of men older than 70 years (1), and one fourth of men older than 70 years have moderate to severe LUTS that impair their quality of life (QOL) (2,3). Thus, BPH and ensuing LUTS represent a significant health issue affecting millions of men. The International Prostate Symptom Score (IPSS; also known as the American Urologic Association Symptom Index) is a validated instrument that quantifies a patient's subjective urinary symptoms on a 35-point scale (4). The IPSS also incorporates a urinary QOL score, which assesses how the patient feels overall about his urinary symptoms. Nearly all studies assessing BPH treatments for LUTS use the IPSS and QOL scores to assess patients before and after treatment. A 3-point change in IPSS is noticeable by a man with LUTS (5), and a 30% reduction in IPSS is considered clinically acceptable for a treatment to be considered effective (6,7). Medical therapies, including a-1 blockers and 5-a reductase inhibitors, are the mainstay of treatment for mild to moderate LUTS. The symptomatic relief is relatively modest, with IPSS improvement in the range of 3-7 points (8). Although generally considered safe, medical

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Section: Hematuria Of Prostatic Originmentioning

confidence: 99%

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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“…PAE has been previously shown to be an alternative to treating BPH, as well as intractable hematuria of prostatic origin [2] , [6] . This option utilizes recent endovascular techniques to selectively occlude arterial feeders to the prostate, resulting in diminished vascularity and prostate size.…”

Section: Discussionmentioning

confidence: 99%

Intractable hematuria due to giant prostatic hyperplasia effectively treated with prostatic artery embolization

Kably

Bode

2020

Asian Journal of Urology

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Giant prostatic hyperplasia (GPH) is a rare pathology traditionally treated with an open suprapubic prostatectomy. This procedure is risky, and fatal hemorrhagic complications can occur. Often, patients with GPH present with diminished renal function due to obstructive nephropathy, making them unfit for less invasive endovascular therapies using traditional contrast agents. Here we present a case of a patient with intractable hematuria due to GPH, as well as diminished renal function, who was successfully treated using prostatic artery embolization with CO 2 digital subtraction arteriography as a contrast agent.

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“…Cone-beam CT should be performed to confirm the proper position of the microcatheter prior to injection of the particles ( Figure 3 ). Compression dressing or closure device is applied to the vascular access site after the procedure has been completed [ 5 , 27 , 29 , 30 ].…”

Section: Methodsmentioning

confidence: 99%

The application of prostate artery embolization in the management of intractable prostate bleeding

Stężewska

Żabicki

et al. 2020

Cent european J Urol

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Introduction Prostate cancer is one of the most common malignancies affecting European men. Sequelae of the advanced malignancy require invasive procedures which may not be eligible especially for old, debilitated patients. The aim of this manuscript is to review the outcomes of prostate artery embolization in the management of refractory bleeding. Material and methods A PubMed database search was done for all English language articles on prostate artery embolization in prostate cancer, published between 2003 and 2019. For current review, information related to number, age of the patients, aetiology of the hematuria, bilateral or unilateral procedure, type of embolic material, technical and clinical success, complications, recurrent hematuria, hematocrit and hemoglobin levels were analyzed. Results A total of 10 original full-text comparative and non-comparative (case series) studies were reviewed. Minor complications described in the literature ranged from 10–50%. After prostate artery embolization, the recurrence of the haematuria occurred in 10–57% of the patients. Moreover, prostate artery embolization successfully treated lower urinary tract symptoms and urinary retention in prostate cancer patients. Conclusions The procedure appears safe, burdened with low risk of complications and accomplishes technical and clinical success. It is a promising option for patients with hemorrhage, but due to the scarcity of data further investigations are needed.

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Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique

Cited by 17 publications

References 26 publications

Intractable hematuria due to giant prostatic hyperplasia effectively treated with prostatic artery embolization

The application of prostate artery embolization in the management of intractable prostate bleeding

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