Role of Trans-Catheter Prostatic Artery Embolization in Management of Benign Prostatic Hyperplasia
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- Category: Vol. 85, December 2017
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Role of Trans-Catheter Prostatic Artery Embolization in Management of Benign Prostatic Hyperplasia, MOMTAZ T. ALLAM, ABD EL-KAREEM H. ABD ALLAH, MOUSTAFA H.M. OTHMAN, HANY SEIF and HASSAN A. ABO-LELLA
Abstract
Background: Prostatic Artery Embolization (PAE) for ИРИ has been shown to be safe and effective in inducing prostatic volume reduction in animals and humans. PAE is a safe and painless outpatient procedure with low morbidity in most cases after failure of medical therapy.
Purpose: To assess efficacy and safety of prostatic artery embolization as a line of treatment for benign prostatic hyperplasia in patients with moderate to severe Lower Urinary Tract Symptoms (LUTS) after failure of medical treatment.
Patients and Methods: Thirty patients were included and their age ranged from 43 to 93 years (mean 68.3+11.00y). All patients complained of moderate to severe LUIS secondary to ВРН. Twenty-seven patients underwent PAE (unilateral n=5 and bilateral n=22) using PVA embolic material. Patients followed-up using IPSS, prostate volume, Quality of Life (QOL) and peak flow rate (Qmax). Three patients technically failed to underwent PAE.
Resulu: Twenty-six patients show IPSS reduction by 0.086% (mean 73.68%+16.8), prostate volume reduction by 14.641.5% (mean 26.16%t7.8), QOL improvement by 0.0-100% (mean 81.3%+24 34) and Qmax improvement by 36.1-805% (mean 62.6%114.29) after one and three months follow-up. Clinical improvement was 196.3%. One patient (3.7%) showed clinical failure after successful bilateral PAE. Minor self-limited complications occurred in 5 patients (18.5) in the form of pelvic pain, burning micturition, hematuria and blood in stool.
Conclusion: PAE is safe and effective line of treatment for patients with moderate to severe LUIS secondary to ВРН after failure of medical treatment. It has low morbidity, good short-term symptomatic control associated with prostate volume reduction and quality of life improvement.