Joao Martins Pisco MD, Presenter: Nothing to Disclose

Luis Campos Pinheiro MD, Abstract Co-Author: Nothing to Disclose

Tiago Bilhim MD, Abstract Co-Author: Nothing to Disclose

Sandra Marisa Duarte MD, Abstract Co-Author: Nothing to Disclose

Jorge Rocha Mendes MD, Abstract Co-Author: Nothing to Disclose

To evaluate whether prostatic arterial embolization (PAE) is a feasible and effective procedure, without sexual dysfunction, in patients with symptomatic benign prostatic hyperplasia (BPH) and to show the short term results.

Twenty four patients, aged 62 - 82 years (mean 74.6 years) with symptomatic BPH, after failure of medical treatment were selected for PAE. Nine patients were in urinary retention with bladder catheters. The patients stopped all prostatic medication one week before PAE and started an anti-inflammatory 2 days before and continued for 5 days following the embolization. The following parameters were evaluated before, 1, 3, 6 and 12 months after PAE: IPSS – international prostate symptom score; QoL - quality of life IIEF – international index of erectile function; PSA – prostate specific antigen; Qmax – peak urinary flow; prostate volume by transrectal ultrasound, and magnetic resonance, and PVR - post-void residual volume. PAE was performed under local anaesthesia, by single femoral approach with a C2F5 catheter and a microcatheter. Non spherical 200 μm polyvinyl alcohol (PVA) particles were used. Twenty one patients were discharged 6 - 8 hours after the procedure and three 18 hours later, the next morning.  

PAE was technically successful in 23 of the 24 patients (95.8%). Only one patient referred pain during the procedure. The control follow-up was performed at 1 and 3 months in all patients, at 6 months in 8 patients and at 12 months in 10 patients. There was a mean follow up of 7.9 months (range 3 - 12 months). The vesical catheter was removed 5 days after the PAE in 3 patients and 10 days in the remaining 6 patients. The symptoms improved in all the 23 patients in whom the embolization was successfully performed, however 5 of them were considered failures due to slight improvement (21.7%). At last follow up, the IPSS decreased 9.8, the Qol decreased 1.3 the IIEF increased 1.1, the PSA decreased 27.2%, the Qmax increased 5.2ml, the prostate volume decreased 28.5% and the PVR decreased 68%. There were 2 urinary infections. There was a major complication due to 1.5 cm square sized of bladder wall ischemia treated by surgical removal.   

PAE is a feasible and effective procedure in patients with symptomatic BPH, with good short term results and without sexual dysfunction.

This is the first report to date of PAE in the treatment of BPH.

Pisco, J, Pinheiro, L, Bilhim, T, Duarte, S, Mendes, J, Embolization of Prostatic Benign Hyperplasia. Short Term Results.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008238.html