Servicio de Urologia Hospital Italiano de Buenos Aires – Argentina.Introduccion: Relatar los resultados preliminares de un estudio clinico institucional sobre embolizacion prostatica como alternativa terapeutica para la hiperplasia prostatica benigna.Material y metodo: Catorce pacientes con edad media de 72,5 anos, por -tadores de sintomas del tracto urinario inferior e hiperplasia prostatica benigna fueron sometidos al tratamiento. Todos los pacientes habian realizado tratamiento medico sin mejoria clinica. El estudio fue aprobado por el comite de etica de protocolos de investigacion de la institucion. Los pacientes fueron evaluados por medio de cuestionarios de IPSS, QOL, IIEF, antigeno prostatico especiﬁco, ecografia con medicion del residuo postmiccional y resonancia magnetica de pelvis antes y a los 30 dias del tratamiento. Cinco pacientes estaban con retencion urinaria y tenian sonda vesical permanente.Resultados: La embolizacion fue realizada con exito en los catorce pacien -tes, en 8 se realizo de forma bilateral y en 6 de forma unilateral. Todos los pacientes fueron tratados bajo anestesia local y de forma ambulatoria. Hubo una reduccion media de 8 puntos del IPSS, 2 puntos del QOL y un in-cremento de 4 puntos del IIEF a los 30 dias de la embolizacion. Se veriﬁco una reduccion media del antigeno prostatico especiﬁco de 45% y del volu-men prostatico de 21%. La ﬂujometria revelo un aumento del ﬂujo maximo de 39% y una reduccion del volumen residual postmiccional de 30%.Entre los pacientes con retencion urinaria se consiguio retirar la sonda vesical en dos de ellos. No se observaron complicaciones mayores que hayan requerido internacion o intervenciones quirurgicas adicionales. Tres pacientes tuvieron una infeccion urinaria baja, 5 hemospermia transitoria, 2 manifestaron ardor transitorio y un paciente hizo retencion urinaria aguda que requirio la colocacion temporaria de una sonda.Conclusiones: Los resultados preliminares de este estudio clinico ins-titucional sugieren que la embolizacion prostatica es una alternativa segura y eﬁcaz para el tratamiento de la hiperplasia prostatica benigna.PALABRAS CLAVE: Embolizacion, hiperplasia prostatica benigna, adenoma prostatico, sintomas del tracto urinario inferior, radiologia intervencionista.Introduction: To report the preliminary results of an institutional clinical study on prostate embolization as a therapeutic alternative for benign prostatic hyperplasia.Material y Method: Fourteen patients with a mean age of 72.5 years su-ffering from low urinary track symptoms and benign prostate hyperpla-sia underwent prostate embolization. All of them had previous medical treatment without clinical improvement. The institutional ethical com-mittee for clinical research approved this study. Patients were evaluated with speciﬁc questionnaires like IPSS, QOL, IIEF, prostatic-speciﬁc antigen (PSA), ultrasound to access post-voided volume and MRI before and 30-days after the procedure. Five patients had permanent bladder catheters.Results: Embolization was successfully achieved in all patients; in 8 patients embolization was performed bilaterally and in 6 only a single prostate side was performed. Procedures were performed under local anesthesia and as outpatients. Outcomes showed a reduction of 8 points in IPSS, 2 points in QOL and an improvement of 4 points in the IIEF 30 days after embolization. Blood level of PSA reduced 45% and the prostate volume reduced 21%. Uroﬂowmetry reveled an improvement of QMax up to 39% and ultrasound demonstrated a reduction in post-voided volume up to 30%. Among the patients under acute retention two were able to remove the bladder catheter. No complications requiring readmissions or additional interventions were observed. Minor compli-cations were observed in ﬁve patients: 3 had urinary track infections, 5 noticed transient hemospermia, 2 referred burning and dysuria and 1 had an acute retention that required a bladder catheter for 25 days. Conclusion: The preliminary results of this institutional clinical study suggest that prostate embolization is an efﬁcient and safe alternative to treat benign prostate hyperplasia.KEY WORDS: Prostatic artery embolization, benign prostate hyperpla-sia, prostate adenoma, luts, interventional radiology.

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Embolización prostática como alternativa de tratamiento para la hiperplasia benigna. Resultados preliminares de un estudio clínico multidisciplinario Prostate embolization as a treatment alternative for benign hyperplasia. Preliminary results of a multidisciplinary clinical study

Benign Prostatic Hyperplasia: TranscatheterArterialEmbolizationas PotentialTreatment—Preliminary

Purpose: To prospectively evaluate the technical feasibility and safety of transcatheter arterial embolization (TAE) of the prostate in healthy pigs. Materials and Methods: The study was approved by the institutional ethics committee for animal research. Sixteen large white male pigs were randomly assigned to the embolization group (n = 8) or control group (n = 8). Selective angiography was performed in all animals after general anesthesia was induced. In the embolization group, microspheres 500–700 μm in diameter were used to occlude the prostatic branches. Three months later, the animals' sexual function while breeding with female pigs was subjectively evaluated by using a three-point scale. At necropsy, the prostates were removed for size measurement and histopathologic examination. Paired Student t and Wilcoxon rank sum tests were used for statistical analysis. Results: TAE was technically successful in all animals, without associated complications. The mean prostate volume after embolization was sign...

Benign prostatic hyperplasia: transcatheter arterial embolization as potential treatment--preliminary study in pigs.

目的 探讨动脉栓塞治疗良性前列腺增生(BPH)的方法及疗效.方法经临床、CT及B超确诊为BPH的患者12例,年龄61～82岁,病程2～16年.剩余尿(RU)平均为138 ml,最大尿流率(Qmax)平均9.6 ml/s,国际症状评分(IPSS)平均24.2分,生活质量评分(QOL)平均4.8分.超选择性动脉造影证实为前列腺供血动脉后,经导管注入聚乙烯醇(PVA)和明胶海绵颗粒进行栓塞.对手术前后IPSS、QOL、Qmax、RU进行比较,采用经直肠超声、CT观察前列腺大小、血流变化,尿道造影了解尿道狭窄程度改善情况.结果 12例患者共完成21支较大前列腺供血动脉的栓塞治疗.其中髂内动脉分支5支,膀胱下动脉分支9支,阴部内动脉分支5支,闭孔动脉分支2支.单侧栓塞3例,双侧栓塞9例.术后IPSS 4.8分、QOL 1.3分、Qmax 18.9 ml/s、RU 0～3 ml,较术前均有明显改善.彩色多谱勒显示前列腺内血流信号明显减弱、最大血流速度减慢,B超或CT检查前列腺体积从平均127 ml缩小到90 ml,缩小71%,X线造影尿道狭窄消失.结论动脉栓塞治疗BPH是一种创伤小、疗效明显、安全性强、并发症少的新方法。

Preliminary study of artery embolization in the treatment of benign prostatic hyperplasia

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Preliminary study of artery embolization in the treatment of benign prostatic hyperplasia