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Objective:To investigate the mid-term efficacy of prostatic artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS), urinary retention (UR) or hematuria secondary to benign prostatic hyperplasia (BPH).Methods:This was a retrospective study conducted from February 2014 to December 2018 in 140 patients who underwent PAE for LUTS, UR or hematuria secondary to BPH, including 85 patients with LUTS (60 patients with LUTS and 25 LUTS combined with hematuria), 52 patients with UR (50 patients with UR and 2 UR combined with hematuria) and 3 patients with hematuria. All patients were followed up for 24 months. Clinical success rates were evaluated. Friedman test was performed to compare the differences in International Prostate Symptom Score (IPSS), quality of life (QoL) score, and prostatic volume (PV) between baseline and follow-up time points (3, 6, 12 and 24 months). A post hoc test was performed by the Bonferroni method.Results:Significant differences in IPSS, QoL score and PV between baseline and follow-up time points were observed in 85 patients with LUTS ( P<0.001 for all), and clinical success rates at 3, 6, 12, 24 months after PAE were 95.3% (81/85), 91.8% (78/85), 87.1%(74/85), 83.5%(71/85). The success rate of extubation in patients with UR within 1 month after PAE was 98.1% (51/52). The average interval from PAE to catheter-independence was (6.8±3.7) days, and clinical success rates were 94.1% (48/51), 92.2% (47/51), 88.2% (45/51), 84.3% (43/51), respectively. The interval from PAE to the resolution of hematuria was (3.4±2.5) days, and clinical success rates were 90.0%(27/30), 90.0%(27/30), 83.3%(25/30), 80.0%(24/30), respectively. Conclusions:PAE was an effective treatment option for symptoms secondary to BPH in mid-term follow up.
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Objective To explore the saffety and efficacy of super-selective prostate artery embolization (PAE) combined with TURP (transurethral resection of prostate) as an alternative method for patients with severe large BPH (＞ 80 ml).Methods From March 2015 to June 2017,a total of 40 patients with large benign prostatic hyperplasia who failed in medical treatment were selected for PAE combined with TURP (18 cases)and TURP (22 cases).In the PAE combined with TURP group,the mean age was (75.0±8.7) years (ranging60-88 years) and the mean prostatic volume was (111.0 ±23.3) ml,ranged from 83 to 145 ml).The international prostate symptom score (IPSS),quality of life (QOL),maximal t rine flow rate (Qmax) and postvoid residual urine(PVR) were(25.2 ±3.6),(5.1 ± 1.0),(6.4 ± 2.3) ml/s and (107.7 ± 32.6) ml,respectively.In the TURP group,the mean age was (76.0 ± 6.9) years (ranging 62-85 years) and the mean prostatic volume was (107.5 ±27.4) ml,ranged from 80 to 150 ml).The IPSS,QOL,Q andPVRwere(24.3±4.2),(4.9 ±0.9),(6.7±2.2)ml/s and (106.6±32.2)ml,respectively.Clinical data of all of patients were analyzed retrospectively,including operative time,estimate blood loss,weight and efficacy of resected tissue,time of continuous bladder irrigation and catheterization,IPSS,QOL,PVR,Q and postoperative complications.Results There were significant differences in the operative time [(75.8 ± 25.1) min vs.(103.2 ± 27.7) min],estimate blood loss [(122.8 ± 33.9) ml vs.(447.6 ± 36.0) ml],weight of resected tissue [(99.9 ± 24.2) g vs.(82.9 ± 15.5) g],efficacy of resected tissue [(76.9 ± 20.7) g/h vs.(41.7 ± 14.2) g/h],continuous bladder irrigation time [(1.4 ± 0.5) d vs.(2.4 ± 0.8) d] and catheterization time [(2.2 ± 0.4) d vs.(3.4 ± 0.6) d] between PAE combined TURP group and TURP group (P ＜ 0.05).The postoperative complications of PAE combined TURP group and TURP group were included secondary hemorrhage (0 case vs.3 cases),secondary TURP (0 case vs.3 cases),temporary urinary incontinence (2 case vs.4 case),urinary tract infection (1 case vs.2 case).After 1-year follow up,the IPSS,QOL,Qmax and PVR of PAE combined TURP group and TURP group were (6.7 ±1.5)and(6.9± 1.5),(2.3 ±0.5) and(2.3 ±0.6),(15.6 ±2.3) ml/s and(15.0 ±2.1) ml/s,(32.8±6.5) ml and(32.3± 8.4)ml,respectively.Both goups were found to have significantly improved in IPSS,QOL,Q and PVR,as compared with preoperative indexes,respectively (P ＜ 0.05).However,there was no significant difference in those indexes between two groups (P ＞ O.05).Conclusions PAE combined TURP could be used a safe and effective therapy for treating patients with LUTS due to large volume (＞ 80 ml) BPH.It has been a priority in less blood,more efficient of resected tissue and less postoperative complications.
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Objective To evaluate the feasibility and safety of prostatic artery embolization (PAE)via transradial approach in treating prostatic hyperplasia.Methods The clinical data of 18 patients with prostatic hyperplasia,who received C-arm CT-guided PAE via left or right radial artery access,were retrospectively analyzed.The following indexes were recorded:arterial spasm and injury of upper limbs,incidence of puncture point bleeding,postoperative radial artery pulse and congestion,blood supply and nerve injury of fingers,the surgical success rate,incidence of perioperative cerebral vascular complications,operation time,radiation dose and clinical curative effect.Results Among the 18 patients,PAE via left radial artery access was employed in 14,and PAE via right radial artery access was performed in 4.Bilateral PAE was carried out in 16 patients,and only unilateral PAE was able to be successfully accomplished in 2 patients as the prostatic artery opening of the other side was tortuous with stenosis.After PAE,decreased radial pulse was observed in one patient and ultrasound examination revealed decreased blood flow.The operation time ranged from 96 min to 245 min.The radiation dose received by the patient varied from 2435 mGy to 4958 mGy with a mean of (3342±156) mGy,which was not significantly different from the radiation dose received by the patients who underwent PAE via femoral artery access during the same study period (P=0.1167).Conclusion In treating prostatic hyperplasia,PAE by using transradial approach is clinically safe and technically feasible.