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Patient Selection for Prostatic Artery Embolization

  • Kavi K. Devulapalli
  • Charles W. Nutting
  • Ari J. Isaacson
Chapter

Abstract

In order to maximize the efficacy of PAE, choosing the appropriate patients is important. The first step is determining if the patient has LUTS secondary to BPH as well as ruling out etiologies that result in bladder dysfunction. This can be achieved through a thorough urologic evaluation that may also include cystoscopy and urodynamic testing. Subsequently, the feasibility of technical success should be assessed by evaluating the arterial anatomy and reviewing the patient’s history for red flags such as prior vascular surgery and evidence of renal dysfunction.

Keywords

Patient selection Uroflowmetry Urodynamics LUTS BPH medication Arterial access 

References

  1. 1.
    Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):1549–57.CrossRefGoogle Scholar
  2. 2.
    Rosen RC, Cappelleri JC, Gendrano N 3rd. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14:226–44.CrossRefGoogle Scholar
  3. 3.
    Yu SCH, Cho CCM, Hung EHY, Chiu PKF, Yee CH, Ng CF. Prostate artery embolization for complete urinary outflow obstruction due to benign prostatic hypertrophy. Cardiovasc Intervent Radiol. 2017;40(1):33–40.CrossRefGoogle Scholar
  4. 4.
    Patel AK, Chapple CR. Benign prostatic hyperplasia: treatment in primary care. BMJ. 2006;333:535–9.CrossRefGoogle Scholar
  5. 5.
    Hatzimouratidis K. A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction. Ther Adv Urol. 2014;6(4):135–47.CrossRefGoogle Scholar
  6. 6.
    Wang M, Guo L, Duan F, Yuan K, Zhang G, Li K, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates. BJU Int. 2016;117:155–64.CrossRefGoogle Scholar
  7. 7.
    Maclean D, Harris M, Drake T, Maher B, Modi S, Dyer J, et al. Factors predicting a good symptomatic outcome after prostate artery embolisation (PAE). Cardiovasc Intervent Radiol. 2018;41(8):1152–9.CrossRefGoogle Scholar
  8. 8.
    Bagla S, Smirniotopoulos JB, Orlando JC, van Breda A, Vadlamudi V. Comparative analysis of prostate volume as a predictor of outcome in prostate artery embolization. J Vasc Interv Radiol. 2015;26(12):1832–8.CrossRefGoogle Scholar
  9. 9.
    Kaplan SA. Identification of the patient with enlarged prostate: diagnosis and guidelines for management. Osteopath Med Prim Care. 2007;1:11.CrossRefGoogle Scholar
  10. 10.
    Frydenberg M, Wijesinha S. Diagnosing prostate cancer—what GPs need to know. Aust Fam Physician. 2007;36:345–7.PubMedGoogle Scholar
  11. 11.
    Gomez C, Bhatia S, Carnevale FC, Narayanan G. Role of urodynamic studies in management of benign prostatic obstruction: a guide for interventional radiologists. J Vasc Interv Radiol. 2017;28:126–33.CrossRefGoogle Scholar
  12. 12.
    Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, et al. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015;67:1099–109.CrossRefGoogle Scholar
  13. 13.
    McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2012;185:1793–803.CrossRefGoogle Scholar
  14. 14.
    Bates CP, Whiteside CG, Turner Warwick R. Synchronous urine pressure flow cystourethrography with special reference to stress and urge incontinence. Br J Urol. 1970;42:714.CrossRefGoogle Scholar
  15. 15.
    Abrams P. Urodynamic techniques. In: Urodynamics. 3rd ed. London: Springer; 2006. p. 17–116.Google Scholar
  16. 16.
    Burnett AL, Wein AJ. Benign prostatic hyperplasia in primary care: what you need to know. J Urol. 2006;175:S19–24.PubMedGoogle Scholar
  17. 17.
    Pereira JA, Bilhim T, Duarte M, Rio Tinto H, Fernandes L, Martins Pisco J. Patient selection and counseling before prostatic arterial embolization. Tech Vasc Interv Radiol. 2012;15:270–5.CrossRefGoogle Scholar
  18. 18.
    Kim JI, Dixon RG, Isaacson AI. Translgluteal prostatic artery enmbolization. J Vasc Interv Radiol. 2016;29(1):90–1.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Kavi K. Devulapalli
    • 1
  • Charles W. Nutting
    • 2
  • Ari J. Isaacson
    • 3
  1. 1.Durham Radiology AssociatesDurhamUSA
  2. 2.Minimally Invasive Procedure SpecialistsParkerUSA
  3. 3.Department of RadiologyUniversity of North Carolina, School of MedicineChapel HillUSA

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