Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It
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Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.
KeywordsBenign prostatic hyperplasia Prostatic artery embolization Cone-beam CT and LUTS
The authors thank Joaquim Mauricio da Motta-Leal-Filho, Eduardo Muracca Yoshinaga, Vanessa Cristina de Paula Rodrigues, Airton Mota Moreira, Octavio Meneghelli Galvão Gonçalves, Andre Moreira de Assis, Ronaldo Hueb Baroni, Antonio Sergio Zafred Marcelino, Luciana Mendes de Oliveira Cerri, Miguel Srougi and Giovanni Guido Cerri for their important collaboration.
Conflict of interest
The authors declare that they have no conflicts of interest.
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