Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery

Hidalgo, D. Salvador; Ureta, M. Bernardello; Sbriglio, M.; Gámez, A. García; Moragas, Jorge; Calama, J. Areal; Castañeda, F. Ágreda

doi:10.1016/j.acuroe.2021.06.008

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Third, our study included 14 catheter-carrier patients, 9 of which achieved spontaneous micturition after the procedure, resulting in a success rate of 64% (Supplementary Table 1 ). Similar results were reported for other minimally invasive techniques such as PAE (65.4–73.1%) [ 27 , 28 ], and slightly lower than the ones described after REZUM in several reviews (83%; 70.3–100%) [ 29 , 30 ].…”

Section: Discussionsupporting

confidence: 86%

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Lo Re,

Polverino,

Rivetti

et al. 2024

World J Urol

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Purpose Transperineal laser ablation (TPLA) is a new minimally-invasive surgical treatment for patients with benign prostatic obstruction (BPO). We report the perioperative and mid-term functional results of the first 100 consecutively patients undergoing TPLA at our institution. Methods Clinical data from consecutive patients undergoing TPLA at our institution from April 2021 to July 2023 were prospectively collected. Primary endpoints were the postoperative changes in IPSS, QoL and MSHQ 3-item questionnaires and in Qmax and post-void residual volume (PVR). Results Overall, 100 consecutive patients underwent the procedure. Median age and prostate volume were 66 (IQR 60–75) years and 50 (IQR 40–70) ml, respectively. In the cohort, 14 (14%) patients had an indwelling catheter and 81 (81%) were under oral BPO therapy at the time of TPLA. Baseline median Qmax (ml/s) and PVR (ml) were 9.1 (IQR 6.9–12) and 90 (IQR 50–150), respectively, while median IPSS and QoL were 18 (IQR 15–23) and 4 (IQR 3–4). At all the follow-up timepoints, the evaluated outcomes on both symptoms and functional parameters showed a statistically significant improvement (p < 0.001). Antegrade ejaculation was preserved in all sexually active patients. No postoperative Clavien-Dindo > 2 complications were recorded. Conclusions TPLA represents a safe option for selected well-informed patients swith LUTS due to BPO. Our prospective study confirms the feasibility and favorable perioperative and functional outcomes in a real-world cohort with heterogenous prostate volumes and patient characteristics.

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Section: Discussionsupporting

confidence: 86%

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Lo Re,

Polverino,

Rivetti

et al. 2024

World J Urol

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“…PAE is a procedure that produces a high degree of radiation exposure to the patient and the interventional radiologist, with DSA acquisitions as the leading source of radiation (Andrade et al 2017; Salvador Hildago et al 2021; Tang et al 2021). Factors such as physician experience and intended unilateral embolization (Schott et al 2019) were significant predictors of decreased radiation exposure during PAE (Svarc et al 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Radiology aims to achieve a balance between radiation exposure and image quality. Known as the ALARA principle (as low as reasonably achievable; Preston 2005), this guideline is essential for image-guided procedures, where patients and clinical staff are exposed to high doses of ionizing radiation (Schernthaner et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Radiation Exposure during Prostatic Artery Embolization: A Single Institution Review

Ngov

Self

Schammel³

et al. 2023

Health Physics

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Prostate artery embolization is a minimally invasive treatment for benign prostatic hyperplasia, and imaging is indispensable for the technical success of this procedure; however, imaging is a major source of radiation exposure for patients and healthcare providers. Radiation emission during prostate artery embolization procedures at a single institution was evaluated to determine radiation exposure with the goal to work toward minimizing exposure. All patients at a single institution that underwent outpatient unilateral/bilateral prostate artery embolization between 4 January 2019 and 16 November 2021 were retrospectively evaluated; data collected included body mass index, prostate volume, and indications for prostate artery embolization. Technical parameters recorded were air kerma, procedure time, fluoroscopy time, number of acquisitions, and intra-procedural imaging modalities. Fisher’s t-test, ANOVA, and chi-square analyses were used as appropriate for statistical analysis (P < 0.05). Overall, 56 patients were included in the study. Body mass index (obesity; P = 0.0017) was a significant predictor of increased air kerma; prostate size and bilateral vs. unilateral prostate artery embolization were not significantly associated with increased air kerma despite the number of acquisitions being significantly different between bilateral and unilateral embolization (P = 0.0064). When evaluating radiation exposure during prostate artery embolization, increased body mass index significantly predicted increased air kerma. Contrary to the literature, the extent of embolization (bilateral vs. unilateral) was not associated with increased air kerma regardless of higher acquisitions and procedure time associated with bilateral prostate artery embolization. Increased radiation protection efforts should be considered for patients with higher body mass index to protect patients and practitioners. Health Phys. 124(0):000-000; 2023

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Arterial embolization in the treatment of benign and malignant prostate lesions

Golovataya,

Gorelov,

Sharafutdinov

et al. 2024

Urology reports (St. - Petersburg)

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Prostatic artery embolization is an X-ray endovascular method for treating patients with lower urinary tract symptoms due to prostate diseases. Over the past 10 years, interest in this problem has grown significantly, as can be judged by the increase in the number and scale of research on this topic. The review article provides information about the effectiveness of this treatment method for benign and malignant prostate tumors. The search for information sources was carried out using the PubMed and eLibrary.ru databases. Key words used are “embolization of prostatic arteries”, “chemoembolization of prostate cancer”, “prostate cancer”, “benign prostatic hyperplasia”, “lower urinary tract symptoms” (in Russian and English). The prospects for embolization of prostatic arteries in urological and oncological practices and the need for more large-scale research in this direction are noted.

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Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery

Cited by 3 publications

References 18 publications

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Radiation Exposure during Prostatic Artery Embolization: A Single Institution Review

Arterial embolization in the treatment of benign and malignant prostate lesions

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