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A Review of Adverse Events Related to Prostatic Artery Embolization for Treatment of Bladder Outlet Obstruction Due to BPH

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Abstract

Introduction

Minimally invasive procedures have gained great importance among the treatments for benign prostate hyperplasia (BPH) due to their low morbidity. Prostate artery embolization has emerged as a safe and effective alternative for patients with large volume BPH, not suited for surgery.

Materials and Methods

Low adverse events rates have been reported following prostate artery embolization and may include dysuria, urinary infection, hematuria, hematospermia, acute urinary retention and rectal bleeding. Although most complaints are reported as side effects, complications can also be superimposed.

Results

The prostate gland is the most common source of complaints following PAE, where the inflammatory process can create a large variety of localized symptoms. Periprostatic organs and structures such as bladder, rectum, penis, seminal vesicle, pelvis, bones and skin may be damaged by nontarget embolization, especially due to the misidentification of the normal vascular anatomy and variants or due to inadvertent embolic reflux. Radiodermatitis may also happen in case of small vessel size, atherosclerosis, the learning curve and long procedure or fluoroscopy times.

Discussion

Regarding safety, it is pivotal to understand the pathophysiology of adverse events following PAE and their standardized reporting. The aim of this article is to discuss adverse events, their management and to review the current literature.

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Authors and Affiliations

  1. Interventional Radiology and Endovascular Surgery Department, Radiology Institute, University of Sao Paulo Medical School, 255, Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP, 05403-000, Brazil

    Airton Mota Moreira, André Moreira de Assis & Francisco Cesar Carnevale

  2. Urology Department, University of Sao Paulo Medical School, 255, Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP, 05403-000, Brazil

    Alberto Azoubel Antunes & Miguel Srougi

  3. Radiology Institute, University of Sao Paulo Medical School, 255, Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP, 05403-000, Brazil

    Giovanni Guido Cerri

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  1. Airton Mota Moreira
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  2. André Moreira de Assis
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  3. Francisco Cesar Carnevale
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Moreira, A.M., de Assis, A.M., Carnevale, F.C. et al. A Review of Adverse Events Related to Prostatic Artery Embolization for Treatment of Bladder Outlet Obstruction Due to BPH. Cardiovasc Intervent Radiol 40, 1490–1500 (2017). https://doi.org/10.1007/s00270-017-1765-3

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