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CardioVascular and Interventional Radiology

, Volume 40, Issue 4, pp 530–536 | Cite as

Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

  • Antonio Rampoldi
  • Fabiane BarbosaEmail author
  • Silvia Secco
  • Carmelo Migliorisi
  • Antonio Galfano
  • Giovanni Prestini
  • Sardis Honoria Harward
  • Dario Di Trapani
  • Pietro Maria Brambillasca
  • Vercelli Ruggero
  • Marco Solcia
  • Francisco Cesar Carnevale
  • Aldo Massimo Bocciardi
Clinical Investigation

Abstract

Purpose

To prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates.

Methods

Patients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters.

Results

A total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome.

Conclusions

PAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.

Keywords

Prostatic artery embolization Acute urinary retention Lower urinary tract symptoms Benign prostatic hyperplasia Indwelling bladder catheterization 

Notes

Compliance with Ethical Standards

Conflict of interest

SHH and FCC are consultants for Merit Medical Systems, Inc.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Antonio Rampoldi
    • 1
  • Fabiane Barbosa
    • 1
    Email author
  • Silvia Secco
    • 2
  • Carmelo Migliorisi
    • 1
  • Antonio Galfano
    • 2
  • Giovanni Prestini
    • 2
  • Sardis Honoria Harward
    • 3
  • Dario Di Trapani
    • 2
  • Pietro Maria Brambillasca
    • 1
  • Vercelli Ruggero
    • 1
  • Marco Solcia
    • 1
  • Francisco Cesar Carnevale
    • 4
  • Aldo Massimo Bocciardi
    • 2
  1. 1.Department of Interventional RadiologyOspedale Niguarda Ca’ GrandaMilanItaly
  2. 2.Department of UrologyOspedale Niguarda Ca’ GrandaMilanItaly
  3. 3.The Dartmouth Institute for Health Policy and Clinical PracticeDartmouth-Hitchcock Medical CenterLebanonUSA
  4. 4.Department of Interventional RadiologyUniversity of Sao Paulo Medical SchoolSao PauloBrazil

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