Gianluca Sampogna1,2, Fabiane Barbosa3, Pietro Maria Brambillasca3, Emanuele Montanari2, Antonio Rampoldi3, Michele Spinelli4. 1. Unit of Neuro-Urology - Unipolar Spinal Unit, Niguarda Hospital, Milan, Italy. 2. Unit of Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. 3. Unit of Interventional Radiology, Niguarda Hospital, Milan, Italy. 4. Unit of Neuro-Urology - Unipolar Spinal Unit, Niguarda Hospital, Milan, Italy. michele.spinelli@ospedaleniguarda.it.
Abstract
STUDY DESIGN: Case series. OBJECTIVES: To assess the safety and efficacy of prostatic artery embolization (PAE) to reduce prostate volume (PV) and facilitate intermittent catheterization (IC) in individuals with concurrent benign prostatic hyperplasia (BPH) and spinal cord injury (SCI). SETTING: Italian tertiary referral center for people with SCI. METHODS: We retrospectively collected all data of individuals undergoing PAE from 2015 to 2020 because of BPH-related problems during IC. PAE was performed under local anesthesia with superselective catheterization of the prostatic arteries. Technical success was defined as bilateral embolization. We determined pre- and post-procedural PV by magnetic resonance imaging. RESULTS: We considered 10 cases with tetraplegia (n = 5) and paraplegia (n = 5). Nine (90%) procedures were technically successful, while we performed monolateral PAE in one case. The median pre-procedural PV was 61 mL. After 6 months, all patients experienced significant PV reduction (median: 19.6%), and 7/7 patients with indwelling urinary catheter started successfully IC. Neither intra- nor post-procedural complications occurred within a median follow-up of 33 months. CONCLUSIONS: PAE proved to be a safe and effective treatment for BPH to facilitate IC in people with SCI. Considering the minimal morbidity of PAE, further multi-center studies are mandatory to draw definitive conclusions and warrant its widespread adoption in this population.
STUDY DESIGN: Case series. OBJECTIVES: To assess the safety and efficacy of prostatic artery embolization (PAE) to reduce prostate volume (PV) and facilitate intermittent catheterization (IC) in individuals with concurrent benign prostatic hyperplasia (BPH) and spinal cord injury (SCI). SETTING: Italian tertiary referral center for people with SCI. METHODS: We retrospectively collected all data of individuals undergoing PAE from 2015 to 2020 because of BPH-related problems during IC. PAE was performed under local anesthesia with superselective catheterization of the prostatic arteries. Technical success was defined as bilateral embolization. We determined pre- and post-procedural PV by magnetic resonance imaging. RESULTS: We considered 10 cases with tetraplegia (n = 5) and paraplegia (n = 5). Nine (90%) procedures were technically successful, while we performed monolateral PAE in one case. The median pre-procedural PV was 61 mL. After 6 months, all patients experienced significant PV reduction (median: 19.6%), and 7/7 patients with indwelling urinary catheter started successfully IC. Neither intra- nor post-procedural complications occurred within a median follow-up of 33 months. CONCLUSIONS: PAE proved to be a safe and effective treatment for BPH to facilitate IC in people with SCI. Considering the minimal morbidity of PAE, further multi-center studies are mandatory to draw definitive conclusions and warrant its widespread adoption in this population.
Authors: Antonio Rampoldi; Fabiane Barbosa; Silvia Secco; Carmelo Migliorisi; Antonio Galfano; Giovanni Prestini; Sardis Honoria Harward; Dario Di Trapani; Pietro Maria Brambillasca; Vercelli Ruggero; Marco Solcia; Francisco Cesar Carnevale; Aldo Massimo Bocciardi Journal: Cardiovasc Intervent Radiol Date: 2017-01-27 Impact factor: 2.740
Authors: João M Pisco; Luis C Pinheiro; Tiago Bilhim; Marisa Duarte; Jorge R Mendes; Antonio G Oliveira Journal: J Vasc Interv Radiol Date: 2011-01 Impact factor: 3.464
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Authors: Nathan E Frenk; Ronaldo H Baroni; Francisco C Carnevale; Octavio M G Gonçalves; Alberto A Antunes; Miguel Srougi; Giovanni G Cerri Journal: AJR Am J Roentgenol Date: 2014-10 Impact factor: 3.959