Charles R Tapping1, Andrew Macdonald2, Mo Hadi2, Chloe Mortensen2, Jeremy Crew3, Andrew Protheroe4, Mark W Little2, Phil Boardman2. 1. Department of Radiology, Churchill Hospital, Old Road, Headington, Oxford, OX3 9LE, UK. Charles.tapping@ouh.nhs.uk. 2. Department of Radiology, Churchill Hospital, Old Road, Headington, Oxford, OX3 9LE, UK. 3. Department of Urology, Churchill Hospital, Old Road, Headington, Oxford, OX3 9LE, UK. 4. Department of Oncology, Churchill Hospital, Old Road, Headington, Oxford, OX3 9LE, UK.
Abstract
PURPOSE: To assess the effectiveness of prostate artery embolization (PAE) in the control of haematuria and in patients with benign prostatic hyperplasia (BPH) and normal upper urinary tracts. SUBJECTS/PATIENTS: Twelve consecutive patients with haematuria were included in the prospective study. All patients had prior imaging and cystoscopy to exclude other causes of haematuria. Patients prostate arteries were embolized with particles (200-500 μm), and they were followed up at 3, 12 and 18 months following the procedure. QOL questionnaires, IPSS, IIEF and clinical review were all employed to assess the success of the treatment. To allow useful comparison, patients were age- and prostate volume-matched and compared to patients treated with PAE for BPH without haematuria. RESULTS: All 12/12 cases were technically successful with bilateral PAE being performed. All cases of haematuria resolved by the 3-month follow-up (100%). There was one case of recurrence during the 12-month follow-up (overall clinical success at 18 months 92%). This was due to over anticoagulation and ceased once corrected. There was a reduction in lower urinary tract symptoms noted by improvements in QOL indices, IPSS and IIEF. There was continued success even if the patient was subsequently anticoagulated. There was no associated sexual dysfunction. There was more prostatic arterial branching and volume of embolic required to achieve stasis in BPH and haematuria than in BPH alone (p < 0.05). CONCLUSION: PAE is a very useful technique for controlling the quite debilitating condition of haematuria in patients with visible haematuria of prostatic origin. Controlling haematuria and BPH allows a significant improvement in QOL.
PURPOSE: To assess the effectiveness of prostate artery embolization (PAE) in the control of haematuria and in patients with benign prostatic hyperplasia (BPH) and normal upper urinary tracts. SUBJECTS/PATIENTS: Twelve consecutive patients with haematuria were included in the prospective study. All patients had prior imaging and cystoscopy to exclude other causes of haematuria. Patients prostate arteries were embolized with particles (200-500 μm), and they were followed up at 3, 12 and 18 months following the procedure. QOL questionnaires, IPSS, IIEF and clinical review were all employed to assess the success of the treatment. To allow useful comparison, patients were age- and prostate volume-matched and compared to patients treated with PAE for BPH without haematuria. RESULTS: All 12/12 cases were technically successful with bilateral PAE being performed. All cases of haematuria resolved by the 3-month follow-up (100%). There was one case of recurrence during the 12-month follow-up (overall clinical success at 18 months 92%). This was due to over anticoagulation and ceased once corrected. There was a reduction in lower urinary tract symptoms noted by improvements in QOL indices, IPSS and IIEF. There was continued success even if the patient was subsequently anticoagulated. There was no associated sexual dysfunction. There was more prostatic arterial branching and volume of embolic required to achieve stasis in BPH and haematuria than in BPH alone (p < 0.05). CONCLUSION:PAE is a very useful technique for controlling the quite debilitating condition of haematuria in patients with visible haematuria of prostatic origin. Controlling haematuria and BPH allows a significant improvement in QOL.
Authors: Ubenicio Silveira Dias; Maurício Ruettimann Liberato de Moura; Publio Cesar Cavalcante Viana; André Moreira de Assis; Antônio Sérgio Zanfred Marcelino; Airton Mota Moreira; Claudia Costa Leite; Giovanni Guido Cerri; Francisco Cesar Carnevale; Natally Horvat Journal: Radiographics Date: 2021-08-20 Impact factor: 6.312