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Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases

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Abstract

Purpose

We report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH).

Methods

All patients were embolized with 100- to 300-μm microspheres alone or in combination with 300- to 500-μm microspheres.

Results

During follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients.

Conclusions

Urethral obstruction after PAE caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.

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Abbreviations

PAE:

Prostate artery embolization

LUTS:

Lower urinary tract symptoms

BPH:

Benign prostatic hyperplasia

TURP:

Transurethral resection of the prostate

BMI:

Body mass index

IPSS:

International prostate symptom score

QoL:

Quality of life

PSA:

Prostate specific antigen

MRI:

Magnetic resonance imaging

Qmax:

Maximum flow rate

DSA:

Digital subtraction angiograms

PErFecTED:

Proximal embolization first, then embolize distal

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Authors and Affiliations

  1. Department of Radiology, University of Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil

    Leandro Cardarelli Leite, Andre Moreira de Assis, Airton Mota Moreira & Francisco Cesar Carnevale

  2. Discipline of Urology, University of Sao Paulo, Sao Paulo, SP, Brazil

    Alberto Azoubel Antunes

  3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA

    Sardis Honoria Harward

Authors
  1. Leandro Cardarelli Leite
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  2. Andre Moreira de Assis
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  3. Airton Mota Moreira
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  4. Sardis Honoria Harward
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  5. Alberto Azoubel Antunes
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  6. Francisco Cesar Carnevale
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Corresponding author

Correspondence to Francisco Cesar Carnevale.

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Conflict of interest

FCC, AMA, AMM and SHH are research consultants to Merit Medical Systems, Inc. FCC receives patent royalties from Merit Medical Systems. No authors received compensation, financial or otherwise, for the present work.

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Leite, L.C., de Assis, A.M., Moreira, A.M. et al. Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases. Cardiovasc Intervent Radiol 40, 937–941 (2017). https://doi.org/10.1007/s00270-017-1584-6

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  • DOI: https://doi.org/10.1007/s00270-017-1584-6

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