醫學研究

良性前列腺增生 Benign prostatic hypertrophy / 腎臟血管平滑肌脂肪瘤 Angiomyolipoma

Prostate artery embolization for complete urinary outflow obstruction due to benign prostatic hypertrophy
 
Yu SC, Cho CC, Hung EH, Chiu PK, Yee CH, Ng CF. Cardiovasc Intervent Radiol. 2017 Jan;40(1):33-40. doi: 10.1007/s00270-016-1502-3. Epub 2016 Nov 16. PMID: 27853823; PMCID: PMC5174140.

 

Abstract

 

Background: We aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC).

 

Materials and methods: In this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100-300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks.

 

Results: Two patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups.

 

Conclusions: PAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.

 

Keywords: Acute retention of urine; Benign prostatic hypertrophy; Embolization; Prostate artery.

 

本頁圖片/檔案 - B05_fig1

Figure 1. Selective arteriogram of the right prostate artery was performed at ipsilateral oblique 50° and caudal tilt 10° before embolization. Prostate vasculature was outlined. The prostate location was hinted with a Foley balloon that was pointed out with arrows (A). Selective arteriograms after embolization showed no contrast staining in the prostate (B)

 

本頁圖片/檔案 - B05_fig2

Figure 2. Selective arteriogram of the left prostate artery was performed at ipsilateral oblique 50° and caudal tilt 10° before embolization. Prostate vasculature was outlined between the urinary bladder on the left and the rectum on the right (A, B). The Foley balloon as pointed out with arrowheads located within the bladder lumen that was almost completely collapsed (A). The intravesical portion of the prostate as pointed out with arrows showed prostate vasculature inside (A, B). Selective arteriogram after embolization showed no contrast staining in the prostate (C)

 

 

Citation:

Yu SC, Cho CC, Hung EH, Chiu PK, Yee CH, Ng CF. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy. Cardiovasc Intervent Radiol. 2017 Jan;40(1):33-40. doi: 10.1007/s00270-016-1502-3. Epub 2016 Nov 16. PMID: 27853823; PMCID: PMC5174140.

 

https://pubmed.ncbi.nlm.nih.gov/27853823/

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