Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists
Male patients over 50 years with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are potential candidates for prostatic artery embolization (PAE). PAE is not a perfect fit for all BPH patients. Careful pre- and postpostprocedural evaluation/consultation with correct select...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-07-01
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| Series: | The Arab Journal of Interventional Radiology |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739302 |
| _version_ | 1819289200182165504 |
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| author | Tiago Bilhim Nuno V. Costa Daniel Torres |
| author_facet | Tiago Bilhim Nuno V. Costa Daniel Torres |
| author_sort | Tiago Bilhim |
| collection | DOAJ |
| description | Male patients over 50 years with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are potential candidates for prostatic artery embolization (PAE). PAE is not a perfect fit for all BPH patients. Careful pre- and postpostprocedural evaluation/consultation with correct selection of patients should be tailored on an individual basis. Evaluated parameters include the following: LUTS severity quantification with validated questionnaires as the international prostate symptom score (IPSS) and quality of life (QoL), erectile and ejaculatory evaluation with validated questionnaires, blood tests including full blood count, coagulation profile, renal function and total/free prostate-specific antigen (PSA), prostate volume measured by multiparametric magnetic resonance (mpMR) of the prostate and/or transrectal ultrasound, uroflowmetry measuring the peak urinary flowrate (Qmax), and postvoid residual urine (PVR). Correct arterial anatomy identification with either computed tomography (CT) angiography, MR angiography, or intraprocedural cone-beam CT (CBCT) are suggested for a confident procedure and avoiding potential complications. The minimally invasive nature of PAE with a faster recovery, preserving the sexual function, and comparable results to standard prostatic surgery make the procedure an attractive choice for many male patients suffering with this condition. Patients should be informed about the potential for higher retreatment rates and shorter duration of treatment effect when compared with standard prostatic surgery. In this comprehensive review, we provide an updated toolbox for all interventional radiologists interested in the PAE practice for patients with BPH. We explain how to evaluate patients during consultation before and after PAE, describe the preprocedural imaging required, explain the technique, and narrate how to optimize outcomes. Finally, we review the level of evidence of PAE for BPH. |
| first_indexed | 2024-12-24T03:03:04Z |
| format | Article |
| id | doaj.art-67ac33d512f8439abc3175f18d63e1ae |
| institution | Directory Open Access Journal |
| issn | 2542-7075 2542-7083 |
| language | English |
| last_indexed | 2024-12-24T03:03:04Z |
| publishDate | 2021-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | The Arab Journal of Interventional Radiology |
| spelling | doaj.art-67ac33d512f8439abc3175f18d63e1ae2022-12-21T17:18:08ZengThieme Medical and Scientific Publishers Pvt. Ltd.The Arab Journal of Interventional Radiology2542-70752542-70832021-07-01050206006710.1055/s-0041-1739302Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional RadiologistsTiago Bilhim0Nuno V. Costa1Daniel Torres2Angiography Unit, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Saint Louis Hospital, Portugal and Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, PortugalAngiography Unit, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Saint Louis Hospital, Portugal and Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, PortugalAngiography Unit, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Saint Louis Hospital, Portugal and Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, PortugalMale patients over 50 years with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are potential candidates for prostatic artery embolization (PAE). PAE is not a perfect fit for all BPH patients. Careful pre- and postpostprocedural evaluation/consultation with correct selection of patients should be tailored on an individual basis. Evaluated parameters include the following: LUTS severity quantification with validated questionnaires as the international prostate symptom score (IPSS) and quality of life (QoL), erectile and ejaculatory evaluation with validated questionnaires, blood tests including full blood count, coagulation profile, renal function and total/free prostate-specific antigen (PSA), prostate volume measured by multiparametric magnetic resonance (mpMR) of the prostate and/or transrectal ultrasound, uroflowmetry measuring the peak urinary flowrate (Qmax), and postvoid residual urine (PVR). Correct arterial anatomy identification with either computed tomography (CT) angiography, MR angiography, or intraprocedural cone-beam CT (CBCT) are suggested for a confident procedure and avoiding potential complications. The minimally invasive nature of PAE with a faster recovery, preserving the sexual function, and comparable results to standard prostatic surgery make the procedure an attractive choice for many male patients suffering with this condition. Patients should be informed about the potential for higher retreatment rates and shorter duration of treatment effect when compared with standard prostatic surgery. In this comprehensive review, we provide an updated toolbox for all interventional radiologists interested in the PAE practice for patients with BPH. We explain how to evaluate patients during consultation before and after PAE, describe the preprocedural imaging required, explain the technique, and narrate how to optimize outcomes. Finally, we review the level of evidence of PAE for BPH.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739302prostatic artery embolizationprostate embolizationbenign prostatic hyperplasialower urinary tract symptoms |
| spellingShingle | Tiago Bilhim Nuno V. Costa Daniel Torres Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists The Arab Journal of Interventional Radiology prostatic artery embolization prostate embolization benign prostatic hyperplasia lower urinary tract symptoms |
| title | Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists |
| title_full | Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists |
| title_fullStr | Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists |
| title_full_unstemmed | Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists |
| title_short | Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists |
| title_sort | prostatic artery embolization for benign prostatic hyperplasia a primer for interventional radiologists |
| topic | prostatic artery embolization prostate embolization benign prostatic hyperplasia lower urinary tract symptoms |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739302 |
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