The Effect of Protective Coil Embolization of Penile Anastomoses during Prostatic Artery Embolization on Erectile Function: A Propensity-Matched Analysis

Maclean, Drew; Vigneswaran, Ganesh; Maher, Ben; Hadi, Mohammed El; Harding, J.; Harris, Mark; Bryant, J. T.; Hacking, Nigel; Modi, Sachin

doi:10.1016/j.jvir.2022.10.023

Cited by 1 publication

(3 citation statements)

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“…Nevertheless, the consequences of the occlusion of the aPA on penile vascularization must be taken into account. A recent study found no difference between a patient who received embolization of penile collateral in terms of erectile function [ 14 ]. These are still debated, despite numerous studies on the subject in the context of radical prostate surgeries for prostate cancer.…”

Section: Tips and Tricks To Perform Prostate Artery Embolization (Pae)mentioning

confidence: 99%

“…Put another way, this means that when an aPA is founded, it is the only supply to the penile in 14% of the case (type III/(type II + III)). By cross-referencing these data with MacLean [ 14 ], who reported around 12% of penile/aPA protection coiling during PAE, we arrived at a number of 1.7% (12% × 14%) of patients who are potentially at risk of protective occlusion of a type III vascularization. We, therefore, recommend before occluding an aPA to ensure that it is not the only artery supplying the penis, in which case the risk of post-occlusion impotence seems real to us.…”

Section: Tips and Tricks To Perform Prostate Artery Embolization (Pae)mentioning

confidence: 99%

“…Prostate vascularization (white stars) arises from small branches along the aPA. In this case, embolization should not be performed without protection of the anastomosis [ 14 ]. Image ( B ): an intra-prostatic capsular shunt (arrowhead) with a high injection rate (0.7 cc/s).…”

Section: Figurementioning

confidence: 99%

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Prostate Artery Embolization: Challenges, Tips, Tricks, and Perspectives

Moulin

Primio

Vignaux

et al. 2022

JPM

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Prostatic artery embolization (PAE) consists of blocking the arteries supplying the prostate to treat benign prostate hypertrophia (BPH). Its effectiveness on both urinary symptoms and flowmetric parameters has now been amply demonstrated by around a hundred studies, including several randomized trials. The main advantage of this procedure is the very low rate of urinary and sexual sequelae, including ejaculatory, with an excellent tolerance profile. The arterial anatomy is a key element for the realization of PAE. Its knowledge makes it possible to anticipate obstacles and prevent potential complications related to nontarget embolization. Nontarget embolization can occur with a small intraprostatic shunt or reflux and has no consequences except some local inflammation symptoms that resolve in a couple of days. Nevertheless, some situations with large arterial shunts arising from the prostatic artery must be recognized (accessory rectal, bladder, or pudendal branches), and must imperatively be protected before embolization, at the risk of exposing oneself to otherwise ischemic complications that are more severe, such as bladder necrosis and skin or mucosal necrosis. This article offers a step-by-step review of the various anatomical and technical key points to ensure technical and clinical success, while avoiding the occurrence of adverse events.

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Section: Tips and Tricks To Perform Prostate Artery Embolization (Pae)mentioning

confidence: 99%

Section: Tips and Tricks To Perform Prostate Artery Embolization (Pae)mentioning

confidence: 99%