2115 ENDOVASCULAR SUPERSELECTIVE EMBOLIZATION OF PROSTATIC ARTERIES AS THE NEW METHOD OF BPH LESS INVASIVE TREATMENT

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112115 ENDOVASCULAR SUPERSELECTIVE EMBOLIZATION OF PROSTATIC ARTERIES AS THE NEW METHOD OF BPH LESS INVASIVE TREATMENT Ivan Dedov, Dmitry Kurbatov, Ivan Sitkin, Alexander Neimark, Ekaterina Yakovets, Alexander Lepetuhin, and Sergey Dubsky Ivan DedovIvan Dedov Moscow, Russian Federation More articles by this author , Dmitry KurbatovDmitry Kurbatov Moscow, Russian Federation More articles by this author , Ivan SitkinIvan Sitkin Moscow, Russian Federation More articles by this author , Alexander NeimarkAlexander Neimark Barnaul, Russian Federation More articles by this author , Ekaterina YakovetsEkaterina Yakovets Barnaul, Russian Federation More articles by this author , Alexander LepetuhinAlexander Lepetuhin Moscow, Russian Federation More articles by this author , and Sergey DubskySergey Dubsky Moscow, Russian Federation More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2311AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventional surgical therapy of benign prostate hyperplasia (BPH) includes transurethral resection (TUR) as the “gold standard” option for the prostate gland that is not larger than 80 grams. In cases of significantly enlarged prostate open prostatectomy should be recommended. However, in patients who suffer from severe general diseases and/or in patients with a gross prostate volume (more than 150 grams) all conventional surgery may cause undesirable complications. In these patients we use the new alternative method of less invasive surgery–endovascular superselective embolization of prostatic arteries (ESEPA). METHODS We have the experience of treatment of 62 men with moderate−to−severe BPH symptoms and prostate enlargement who underwent ESEPA during the period from September 2008 till November 2010. The patients had total prostate volume of 105−248 grams (median 160 grams), middle IPSS score − 22, middle urinary flow rate (Qmax) 5,7ml/sec. and serum PSA 1.5−3.5 (middle 2.34) ng/mL. 38 patients suffered Diabetes Mellitus tipe2. ESEPA included puncture of left femoral or axliraris arteries, staggered selective cateterisation of vesicalis inferior and prostatic arteries and further angiographic visualization of BPH. For arteries embolisation we have used PVA (Cook) 300μ. End point of embolization : blocked artery supply in prostate nodules and arterial reflux. RESULTS There were no any peri- and postoperative complications, such as bleeding, haematoma, tissue and organ necrosis, urinary retention, and no acute renal failure. Postoperative period included low intermittent perineal pain in 24 pts (37,5%) who did not need analgeticts. All men noticed significant improvement of LUTS 3–5 days just after the procedure. All patients were totally satisfied in 3 months - the middle IPSS score was 7,3. In 12 months, the middle IPSS score was 4,2 and it was significantly (p<0.001) lower than before the treatment. Middle Qmax after 12 month became 15,8 ml/sec. After 24 months of following up these data, they were just the same in 58 (92%) patients. CONCLUSIONS Our results demonstrate that ESEPA may be considered as the real alternative technology for BPH treatment in patients with large prostate volume and/or with high risk of surgery. Highly attractive advantages of ESEPA include minimum inpatient period, almost total absence of complications, fast and careful restoring of patient's voiding and quality of life. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e846 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ivan Dedov Moscow, Russian Federation More articles by this author Dmitry Kurbatov Moscow, Russian Federation More articles by this author Ivan Sitkin Moscow, Russian Federation More articles by this author Alexander Neimark Barnaul, Russian Federation More articles by this author Ekaterina Yakovets Barnaul, Russian Federation More articles by this author Alexander Lepetuhin Moscow, Russian Federation More articles by this author Sergey Dubsky Moscow, Russian Federation More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...