Prostatic artery embolization (PAE) is an alternative treatment for benign prostatic hyperplasia. Complications are primarily related to non-target embolization. We report a case of ischemic rectitis in a 76-year-old man with significant lower urinary tract symptoms due to benign prostatic hyperplasia, probably related to nontarget embolization. Magnetic resonance imaging revealed an 85.5-g prostate and urodynamic studies confirmed Inferior vesical obstruction. PAE was performed bilaterally. During the first 3 days of follow-up, a small amount of blood mixed in the stool was observed. Colonoscopy identified rectal ulcers at day 4, which had then disappeared by day 16 post PAE without treatment. PAE is a safe, effective procedure with a low complication rate, but interventionalists should be aware of the risk of rectal nontarget embolization.
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Conflict of interest
The authors declare that they have no conflict of interest.
Moore KL, Agur AMR, Dalley A (2008) Pelvis and perineum. Essential clinical anatomy. Lippincott Williams & Wilkins, Baltimore, pp 205–271Google Scholar
Clegg EJ (1955) The arterial supply of the human prostate and seminal vesicles. J Anat 89:209–216PubMedGoogle Scholar
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA et al (2013) Quality of life and clinical symptoms improvement support prostatic artery embolization for patients with acute urinary retention due to benign prostatic hyperplasia. J Vasc Interv Radiol 24:535–542PubMedCrossRefGoogle Scholar
Pisco JM, Pinheiro LC, Bilhim T et al (2011) Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol 22:11–19PubMedCrossRefGoogle Scholar
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA et al (2011) Midterm follow-up after prostate embolization in two patients with benign prostatic hyperplasia. Cardiovasc Intervent Radiol 34:1330–1333PubMedCrossRefGoogle Scholar
Pisco JM, Rio Tinto H, Campos Pinheiro L et al (2013) Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol 23(9):2561–2572PubMedCrossRefGoogle Scholar
Bilhim T, Pisco JM, Furtado A et al (2011) Prostatic arterial supply: demonstration by multirow detector Angio CT and Catheter Angiography. Eur Radiol 21:1119–1126PubMedCrossRefGoogle Scholar
Miyayama S, Yamashiro M, Hashimoto M et al (2013) Identification of small hepatocellular carcinoma and tumor-feeding branches with cone-beam CT guidance technology during transcatheter arterial chemoembolization. J Vasc Interv Radiol 24:501–508PubMedCrossRefGoogle Scholar
Antunes AA, Carnevale FC, da Motta-Leal-Filho JM et al (2013) Clinical, laboratorial and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia: a prospective single center pilot study. Cardiovasc Intervent Radiol 36(4):978–986PubMedCrossRefGoogle Scholar
Carnevale FC, Antunes AA, da Motta Leal Filho JM et al (2010) Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminar results in two patients. Cardiovasc Intervent Radiol 33:355–361PubMedCrossRefGoogle Scholar