Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Wang, Xiaoyan; Chai, Yumeng; Huang, Wenhui; Zhang, Yong

doi:10.12998/wjcc.v10.i32.11812

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…Regarding the e cacy outcomes, the improvements in IPSS/QoL scores and the objective endpoints such as Qmax, prostatic volume and PSA levels (Table 3) were somewhat greater than historically described in multiple single center series and metanalyses (2)(3)(4)(5)(6)(7)(19)(20) and lasted during the 12-month follow-up. Although these ndings could be related to the small sample size, it is possible that a more aggressive embolization endpoint due to a lower risk of microspheres re ux could have also played an important role.…”

Section: Discussionmentioning

confidence: 80%

“…Prostatic artery embolization (PAE) is considered a minimally invasive procedure to treat lower urinary tract symptoms attributed to benign prostatic hyperplasia (LUTS/BPH), leading to improvement of all objective urological outcomes, as well as the quality of life of patients suffering from the disease (1)(2)(3)(4)(5)(6)(7). Also, PAE presents with a favorable safety pro le, and is performed in an outpatient basis (8).…”

Section: Introductionmentioning

confidence: 99%

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Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

Assis

Kawakami

Moreira

et al. 2022

Preprint

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Purpose: To describe the initial experience regarding efficacy and safety of Prostatic Artery Embolization (PAE) using a reflux control microcatheter. Materials and methods: This is a prospective, single-center investigation that included 10 patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline, 3-month and 12-month efficacy endpoints were obtained for all patients, and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging (MRI) and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. Complications were assessed using the Cirse classification system. Results: Ten patients entered statistical analysis and presented with significant LUTS improvement 12 months after PAE, as follows: mean IPSS reduction of 86.6% (2.8 vs. 20.7, -17.9, P < 0.001), mean QoL reduction of 79.4% (1.1 vs. 5.4, -4.3, P < 0.001), mean prostatic volume reduction of 38.4% (69.3 cm3 vs. 112.5 cm3, - 43.2 cm3, P < 0.001), mean peak urinary flow (Qmax) increase of 199.4% (19.9 mL/s vs. 6.6 mL/s, +13.3 mL/s, P = 0.006) and mean PSA reduction of 50.1% (3.0 ng/mL vs. 6.1 ng/mL, -3.0 ng/mL, P < 0.001). One patient (10%) needed transurethral resection of the prostate (TURP) after PAE due to a ball-valve effect. One patient (10%) needed coil protective embolization of a high flow intraprostatic anastomosis. One microcatether (10%) needed to be replaced during PAE due to occlusion. Non-target embolization was not observed in the cohort.Conclusion: This initial experience suggests that PAE using a reflux control microcatheter is effective and safe for the treatment of LUTS attributed to BPH. High flow intraprostatic anastomosis still need coil protective embolization to avoid NTE even with the use of reflux-control microcatheters.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

Assis

Kawakami

Moreira

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…The case presented here is unusual because, despite the patient not being a viable candidate for surgery, he was still able to receive life-altering treatment with PAE to alleviate his chronic LUTS and indirectly reduce his IBH. When compared with more invasive surgical procedures for BPH, such as transurethral resection of the prostate (TURP), PAE has a lower risk of urinary incontinence and postoperative sexual side effects [ 10 ]. For patients that pursue PAE, favorable outcomes have been reported for 75-80% of men [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Inguinal Bladder Hernia Indirectly Treated With Prostate Artery Embolization

Garfinkel,

Tanwar,

Larson

2023

Cureus

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An inguinal bladder hernia (IBH) is an abnormal protrusion of the bladder into the inguinal canal accompanied by a peritoneum sheath that creates the hernia sac. Clinical presentations vary greatly from lower urinary tract symptoms (LUTS) and reduction in scrotal size after voiding to being entirely asymptomatic. Since inguinal bladder hernias are uncommon and often accompanied by varied and nonspecific symptoms, it is challenging to diagnose and rarely included in differentials. Currently, computerized tomography (CT) imaging with contrast or voiding cystourethrography is recommended for diagnosis. There is no consensus on the best treatment for inguinal bladder hernias, with options ranging from laparoscopic repair to catheterization. In this study, we report the case of inguinal bladder hernia in an 86-year-old male presenting with symptoms of recurrent hematuria and two failed voiding trials after a Foley catheter placement from prostatomegaly resulting in bladder diverticula, and IBH. He was treated with prostate artery embolization (PAE) to address LUTS related to benign prostatic hyperplasia (BPH). The resultant decreased prostatic volume resolved his symptoms of IBH, hematuria, and urinary retention.

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“…Prostatic artery embolization (PAE) was later used in high-surgical-risk patients with acute urinary retention who had IBC, and eventually emerged as a potential innovative technique for selected patients as a minimally invasive alternative treatment to TURP in patients with moderate to severe BPH determining urinary tract symptoms and/or bladder outlet obstruction. In all patients with LUTS, PAE proved to be a minimally invasive treatment option for BPH and was shown to be safe and effective in reducing prostatic volume and improving LUTS relating to BPH [ 10 , 11 ] with a low morbidity rate and lower incidence of sexual dysfunction due to retrograde ejaculation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Prostate Artery Embolization in the Treatment of Massive Intractable Bleeding from Prostatic Neoplasms: A Case Report and Systematic Review

Moramarco,

Grande,

Vertemati

et al. 2023

JCM

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Lower urinary tract symptoms (LUTS) and hematuria are common symptoms in men with neoplasms, mainly affecting the elderly population. Prostatic arterial embolization (PAE) is a minimally invasive procedure that has shown promising results in managing LUTS and massive intractable prostatic hematuria in patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa). A few studies, however, have provided valuable insights into the durability and efficacy of PAE focusing on the long-term effectiveness, quality of life, and cancer-specific control of hemostasis and urinary symptoms. As a result of concomitant cardiovascular conditions, these patients often take anticoagulants or antithrombotics, which can worsen their hematuria and clinical status. Transurethral resection of the prostate (TURP) is considered a very high-risk procedure, even without massive bleeding, and requires discontinuation of vitamin K antagonists and antiplatelet therapies. Such patients usually have their surgery postponed, and PAE should be considered a safe alternative treatment. We aimed to report a narrative review from 1976 to June 2023 of the current state of PAE for massive and intractable hematuria, highlighting recent developments in this technique, including prospective cohort studies, and focusing on long-term outcome, safety, and complication management of patients with prostatic neoplasms who develop significant hemorrhagic symptoms. Additionally, we present a case report and a simple algorithm for treating intractable bleeding in a 92-year-old man with PCa and massive hematuria.

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Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Cited by 5 publications

References 30 publications

Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

Inguinal Bladder Hernia Indirectly Treated With Prostate Artery Embolization

Prostate Artery Embolization in the Treatment of Massive Intractable Bleeding from Prostatic Neoplasms: A Case Report and Systematic Review

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