prostatic artery embolization

Prostatic artery embolization (PAE) is a minimally invasive procedure utilized to treat benign prostatic hyperplasia (BPH).

Indications

PAE has been used for controlling prostatic hemorrhage (such as that associated prostate cancer) since 1970. However, its use in the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hypertrophy in humans was first published in 2010 by Carnevale et al. following several articles on PAE based on animal studies.

Procedure

The prostate receives its blood supply from the prostatic arteries, which arise as a single or paired vessels on each side of the pelvis. PAE is usually performed via a single common femoral artery puncture. Super-selective embolization of the prostatic arteries result in ischemic necrosis of the gland followed by its shrinkage and subsequent reduction in the symptoms of LUTS.

Equipment

Three embolizing materials have been used in the published articles of PAE for the use in human . Trisacryl gelatin microspheres, nonspherical polyvinyl alcohol particles and hydrogel microspheres.

Complications

Recognized complications include :

• pain
• dysuria
• hematuria and/or hematospermia
• acute urinary retention
• urinary tract infection
• prostate infarction
• complications of femoral artery puncture: hematoma or femoral artery pseudoaneurysm
• non-target embolization: vessels supplying the bladder, rectum and penis

Outcome

Symptomatic relief starts to occur within days in most cases of lower urinary tract symptoms , and side effects are generally mild. The typical urosurgical complication such as bleeding requiring transfusion, bladder incontinence, and erectile dysfunction, have not been reported with PAE. Quality of life scores suggest that patients are satisfied with their urinary symptoms following the treatment .

Siehe auch:

• benigne Prostatahyperplasie
• Arterien der Prostata
• refractory haematuria of prostatic origin (RHPO)

und weiter:

• refractory haematuria of prostatic origin