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Prostatic Artery Embolization

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Treatment of Benign Prostatic Hyperplasia: Modern Alternative to Transurethral Resection of the Prostate

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Abstract

Benign prostatic hyperplasia (BPH) affects a significant proportion of men and its prevalence increases with age. Moderate or severe lower urinary tract symptoms (LUTS) caused by BPH will occur in approximately one quarter of men in their 50s and in approximately half of all men 80 years or older. When medical control of symptoms fails, and/or complications occur, transurethral resection of the prostate (TURP) is attempted. Novel minimally invasive techniques (MIT) have been introduced in recent years with the aim of reducing complications, costs, and length of stay, while equaling or bettering the functional outcomes of conventional TURP. Prostatic arterial embolization (PAE) technique has emerged as an interesting approach in the quest for a nonsurgical alternative to standard BPH treatment for patients that do not respond to medical treatment. Although comparative studies are lacking, preliminary results suggest short-term outcomes better than medical therapy but likely inferior to minimally invasive therapy. Long-term outcomes remain unknown and are surely necessary to establish PAE as a standard of care.

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References

  1. Andersson KE, et al. Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: pathophysiology and mechanism(s) of action. Neurourol Urodyn. 2011;30(3):292–301.

    Article  PubMed  CAS  Google Scholar 

  2. McVary KT. BPH: epidemiology and comorbidities. Am J Manag Care. 2006;12(5 Suppl):S122–8.

    PubMed  Google Scholar 

  3. Madersbacher S, et al. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol. 2004;46(5):547–54.

    Article  PubMed  Google Scholar 

  4. McVary KT, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793–803.

    Article  PubMed  Google Scholar 

  5. Oelke M, et al. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur Urol. 2012;61(5):917–25.

    Article  PubMed  CAS  Google Scholar 

  6. Burnett AL, Wein AJ. Benign prostatic hyperplasia in primary care: what you need to know. J Urol. 2006;175(3 Pt 2):S19–24.

    Article  PubMed  Google Scholar 

  7. Baazeem A, Elhilali MM. Surgical management of benign prostatic hyperplasia: current evidence. Nat Clin Pract Urol. 2008;5(10):540–9.

    Article  PubMed  Google Scholar 

  8. Varkarakis J, Bartsch G, Horninger W. Long-term morbidity and mortality of transurethral prostatectomy: a 10-year follow-up. Prostate. 2004;58(3):248–51.

    Article  PubMed  Google Scholar 

  9. Mitchell ME, et al. Control of massive prostatic bleeding with angiographic techniques. J Urol. 1976;115(6):692–5.

    PubMed  CAS  Google Scholar 

  10. Bischoff W, Goerttler U. Successful intra-arterial embolization of bleeding carcinoma of the prostate (author’s transl). Urologe A. 1977;16(2):99–102.

    PubMed  CAS  Google Scholar 

  11. DeMeritt JS, et al. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol. 2000;11(6):767–70.

    Article  PubMed  CAS  Google Scholar 

  12. Barbieri A, et al. Massive hematuria after transurethral resection of the prostate: management by intra-arterial embolization. Urol Int. 2002;69(4):318–20.

    Article  PubMed  Google Scholar 

  13. Jeon GS, et al. The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: a pilot study. J Vasc Interv Radiol. 2009;20(3):384–90.

    Article  PubMed  Google Scholar 

  14. Sun F, et al. Transarterial prostatic embolization: initial experience in a canine model. AJR Am J Roentgenol. 2011;197(2):495–501.

    Article  PubMed  Google Scholar 

  15. Sun F, et al. Benign prostatic hyperplasia: transcatheter arterial embolization as potential treatment–preliminary study in pigs. Radiology. 2008;246(3):783–9.

    Article  PubMed  Google Scholar 

  16. Bilhim T, et al. Prostatic arterial supply: anatomic and imaging findings relevant for selective arterial embolization. J Vasc Interv Radiol. 2012;23(11):1403–15.

    Article  PubMed  Google Scholar 

  17. Bilhim T, et al. Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol. 2013;24:1595–602.

    Article  PubMed  Google Scholar 

  18. Pereira JA, et al. Radiologic anatomy of arteriogenic erectile dysfunction: a systematized approach. Acta Med Port. 2013;26(3):219–25.

    PubMed  Google Scholar 

  19. Pisco JM, et al. Erratum to: Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol. 2013;23(9):2573–4.

    Article  Google Scholar 

  20. Pisco JM, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol. 2013;23(9):2561–72.

    Article  PubMed  Google Scholar 

  21. Pais D, et al. Sciatic nerve high division: two different anatomical variants. Acta Med Port. 2013;26(3):208–11.

    PubMed  Google Scholar 

  22. Bilhim T, et al. Middle rectal artery: myth or reality? Retrospective study with CT angiography and digital subtraction angiography. Surg Radiol Anat. 2013;35(6):517–22.

    Article  PubMed  Google Scholar 

  23. Bilhim T, et al. Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement. Cardiovasc Intervent Radiol. 2013;36(2):403–11.

    Article  PubMed  Google Scholar 

  24. Bilhim T, et al. Radiological anatomy of prostatic arteries. Tech Vasc Interv Radiol. 2012;15(4):276–85.

    Article  PubMed  Google Scholar 

  25. Bouissou H, Talazac A. Arterial vascularization of the normal and the pathological prostate. Ann Anat Pathol (Paris). 1959;4(1):63–79.

    CAS  Google Scholar 

  26. Flocks RH. The arterial distribution within the prostate gland; its role in transurethral prostatic resection. J Urol. 1937;37:524–48.

    Google Scholar 

  27. Ambrosio JD, De Almeida JS, De Souza A. Origin of prostatic arteries in man. Rev Paul Med. 1980;96(3–4):52–5.

    PubMed  CAS  Google Scholar 

  28. Bilhim T, et al. Prostatic arterial supply: demonstration by multirow detector angio CT and catheter angiography. Eur Radiol. 2011;21(5):1119–26.

    Article  PubMed  Google Scholar 

  29. Pereira JA, et al. Patient selection and counseling before prostatic arterial embolization. Tech Vasc Interv Radiol. 2012;15(4):270–5.

    Article  Google Scholar 

  30. Carnevale FC, Antunes AA. Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How i do it. Cardiovasc Intervent Radiol. 2013;36:1452–63.

    Article  PubMed  Google Scholar 

  31. Antunes AA, et al. Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Intervent Radiol. 2013;36(4):978–86.

    Article  PubMed  Google Scholar 

  32. Pisco J, et al. Prostatic arterial embolization for benign prostatic hyperplasia: short- and intermediate-term results. Radiology. 2013;266(2):668–77.

    Article  PubMed  Google Scholar 

  33. Fernandes L, et al. Prostatic arterial embolization: post-procedural follow-up. Tech Vasc Interv Radiol. 2012;15(4):294–9.

    Article  PubMed  Google Scholar 

  34. Bagla S, et al. Utility of cone-beam CT imaging in prostatic artery embolization. J Vasc Interv Radiol. 2013;24:1603–7.

    Article  PubMed  Google Scholar 

  35. Moreira AM, et al. Transient Ischemic rectitis as a potential complication after prostatic artery embolization: case report and review of the literature. Cardiovasc Intervent Radiol. 2013;36(6):1690–4.

    Article  PubMed  Google Scholar 

  36. Rio Tinto H, et al. Prostatic artery embolization in the treatment of benign prostatic hyperplasia: short and medium follow-up. Tech Vasc Interv Radiol. 2012;15(4):290–3.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Urology Department, University of Montreal Hospital Center (CHUM), Laval, QC, Canada

    Roger Valdivieso O’Donova M.D.

  2. Section of Urology, Department of Surgery, Centre Hospitalier de l’Université de Montréal, CHUM, Montreal, QC, Canada

    Pierre-Alain Hueber M.D., Ph.D.

  3. Urology Department, School of Medicine, University of Montreal, Montreal, QC, Canada

    Naeem Bhojani M.D., FRCSC

  4. Surgery Department, Brigham and Women’s Hospital, Boston, MA, USA

    Quoc-Dien Trinh M.D.

  5. Robotic Surgery, Section of Urology, University of Montreal Health Center (CHUM), 235, boul. René-Levesque Est, suite 301, Montreal, QC, H2X 1N8, Canada

    Kevin C. Zorn M.D.

Authors
  1. Roger Valdivieso O’Donova M.D.
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  2. Pierre-Alain Hueber M.D., Ph.D.
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  3. Naeem Bhojani M.D., FRCSC
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  4. Quoc-Dien Trinh M.D.
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  5. Kevin C. Zorn M.D.
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Corresponding author

Correspondence to Kevin C. Zorn M.D. .

Editor information

Editors and Affiliations

  1. Department of Urology, Weill Cornell Medical College, New York, New York, USA

    Bilal Chughtai

  2. Department of Urology, Weill Cornell Medical College, New York, New York, USA

    Alexis E. Te

  3. Department of Urology, Weill Cornell Medical College, New York, New York, USA

    Steven A. Kaplan

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O’Donova, R.V., Hueber, PA., Bhojani, N., Trinh, QD., Zorn, K.C. (2015). Prostatic Artery Embolization. In: Chughtai, B., Te, A., Kaplan, S. (eds) Treatment of Benign Prostatic Hyperplasia: Modern Alternative to Transurethral Resection of the Prostate. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1587-3_20

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  • DOI: https://doi.org/10.1007/978-1-4939-1587-3_20

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1586-6

  • Online ISBN: 978-1-4939-1587-3

  • eBook Packages: MedicineMedicine (R0)

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