Effect of superselective prostatic artery embolization on benign prostatic hyperplasia
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INTERVENTIONAL RADIOLOGY
Effect of superselective prostatic artery embolization on benign prostatic hyperplasia Yi Tang1,2 · Jian‑Hui Zhang1 · Yao‑bin Zhu3 · Shao‑Jie Wu1,2 · Sen‑Lin Cai1,2 · Yan‑Feng Zhou1,2 · Xin Qian1,2 · Jie‑Wei Luo1,4 · Zhu‑Ting Fang1,2 Received: 2 May 2020 / Revised: 16 August 2020 / Accepted: 21 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To investigate the safety and effectiveness of superselective prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH). Methods Sixty-five patients diagnosed with BPH in Fujian Provincial Hospital between December 2014 and July 2019 were included. Patients with ineffective drug treatment after 6 months, who refused surgery, or who were unsuitable for surgery were included. We observed postoperative complications, followed up at 1, 3, and 6 months, compared clinical symptoms, and monitored changes in prostate-specific antigen (PSA) and prostatic volume (PV) before and after treatment. Results Of the 65 patients, 58 (89.23%) successfully received PAE; 44 and 14 bilateral and unilateral embolization, respectively. Clinical efficacy was 94.83% (55/58) after the 6-month follow-up. Postoperative PV, International Prostate Symptom Score, quality of life, maximum flow rate, and post-void residual significantly improved after 6 months (P 18 points and QOL > 3 points; (4) patient with acute urinary retention but refused medication; (5) refused surgery or those who were frail or had severe medical illnesses and would not have endured surgery. Exclusion criteria [5–7]: (1) malignant tumor; (2) giant bladder diverticulum (maximum diameter > 5 cm); (3) giant bladder stones (maximum diameter > 2 cm); (4) detrusor dysfunction; (5) neurogenic bladder; (6) chronic renal failure (glomerular filtration rate 133 µmol/l); (7) active urinary tract infection; (8) abnormal coagulation function; (9) allergy to contrast agents containing iodine; (10) severe internal iliac artery and/or PA atherosclerosis and tortuosity; (11) iliac aneurysm or internal iliac artery occlusion; (12) lack of cooperation by the patient owing to involuntary limbs movement during the procedure; (13) history of bladder surgery and bilateral iliac artery embolization. Transrectal biopsy was performed in patients with PSA ≥ 4.0 ng/mL and/or space-occupying lesions on radiological findings to exclude prostate cancer [8].
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Abdominal Radiology
PAE treatment process (1) PA angiography: One group of doctors performed PAE in this group. Processes included routine genital skin preparation, insertion of F14 pure silicone double-lumen ureter, injection of contrast agent into the balloon for PA identification during the procedure, and routine bilateral groin disinfection. The right or left femoral artery was punctured using the Seldinger technique under local anesthesia. A 5F hepatic artery catheter (Terumo, Japan) or Cobra catheter (Cook, USA) was used on the same side at 37° oblique position, and the image intensifier
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