Francisco Cesar Carnevale, Presenter: Nothing to Disclose

Symptomatic benign prostatic hyperplasia (BPH) occurs in the sixth decade, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency and urgency. Prostatectomy is considered to be the traditional surgical method of management. We report the preliminary results of eight patients with acute urinary retention due to BPH, treated by prostate artery embolization (PAE). Patients were investigated using the International Prostate Symptom Score, digital rectal examination, urodynamic testing, transrectal ultrasound (US), magnetic resonance imaging (MRI), uroflowmetry and post void residual urine volume. Clinical and imaging follow-up were performed at 1, 3, 6, 18 months and every year after PAE. Procedure was performed under local anesthesia; embolization of the prostate arteries was performed with a microcatheter and 300-500μm microspheres using complete stasis as the endpoint. Technical and clinical success was 75%. There was no major complication. Patients urinated spontaneously from 6-15 days (mean, 10 days) after removal of the urethral catheter. At 1-month follow-up (7 patients), measured by US and MRI, mean prostate reduction was 22%. At 3-month follow-up (4/7 patients), measured by US and MRI, mean prostate reduction was 30% and 27%, respectively. We´ve observed a continuous regression rate of the prostate size (2/7 patients) until the sixth month follow-up (mean, US: 33% and MRI: 38%) and stalization at 18-month follow-up (mean, US: 30% and MRI: 33%), with a tendency of increasing in the patient submitted to unilateral PAE. Early results of PAE show a promising potential alternative of treatment for BPH.

Carnevale, F, Embolization of Prostatic Adenoma.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9016470.html