ABSTRACT
Objective Prostatic artery embolization (PAE) for the treatment of patients with symptomatic benign prostatic hyperplasia (BPH) is believed to be a safe procedure with a low risk of adverse side effects. Artery embolization is a viable treatment option in patients who are refractory to the classic noninvasive treatments. Knowledge of the histological characteristics of prostate tissue following the procedure is still limited. In this study, we describe the microscopic aspects of the prostate following PAE for BPH. Materials and Methods Two patients underwent transurethral resections of the prostate (TURP) after PAE. Embolizations were performed under local anesthesia with an initial pelvic angiography to evaluate the iliac vessels and the prostate arteries using a 2.8 French microcatheter. The prostate was embolized with 300-500µm Microspheres (Embosphere®), using complete blood stasis as the end point. The prostate tissues were analyzed histologically to characterize the effects of the embolization. Results The embolic material within the prostate tissue was easily identified as homogeneous, bright eosin-red spheroids filling the vessel lumens. Ischemic necrosis surrounded or not by chronic inflammatory reactions containing macrophages were considered as a result of the artery embolization. Also, some aspects related to the healing process were observed being fibrotic nodules surrounded by glands with squamous metaplasia of the epithelial lining the most important. In the remaining sections, due to the precocious surgical intervention, the classic findings of BPH were still present with the glandular and stromal hyperplasia associated with nonspecific chronic prostatitis. Conclusions This is the first description of prostate histology in BPH patients treated by PAE, a new procedure that is being used increasingly as a therapeutic intervention. The recognition of the changes caused by this new modality of treatment has ...
Subject(s)
Aged , Humans , Male , Embolization, Therapeutic/methods , Prostate/blood supply , Prostate/pathology , Prostatic Hyperplasia/pathology , Prostatic Hyperplasia/therapy , Arteries , Biopsy , Necrosis , Treatment OutcomeABSTRACT
É apresentado um caso de recém-nascido prematuro com peso de 2,25O gramas e polidrâmnio. No primeiro dia de vida apresentou quadro sugestivo de obstruçao intestinal alta. A radiografia simples de abdome confirmava o achado prévio de obstruçao intestinal, observando-se imagem de ar no estômago e na primeira porçao duodenal (dupla bolha). A radiografia contrastada do esôfago e estômago nao apresentou progressao do contraste a partir da segunda porçao duodenal. No segundo dia de vida, na laparotomia observou-se estenose ao nível da segunda porçao do duodeno por pâncreas anular. Foi realizada uma duodeno-jejuno-anastomose látero-lateral, nao sendo observadas outras anomalias. O recém-nascido apresentou boa evoluçao pós-operatória. O exame contrastado, um mês após a cirurgia, apresentava-se normal.