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Multicenter Study
. 2020 May-Jun;14(3):1557988320923910.
doi: 10.1177/1557988320923910.

Prostatic Artery Embolization for Benign Prostatic Hyperplasia Treatment: A Russian Multicenter Study in More Than 1,000 Treated Patients

Armais Kamalov  1   2 , Sergei Kapranov  3 , Alexander Neymark  4 , Dmitry Kurbatov  5 , Boris Neymark  4 , Valery Karpov  1   2 , Boris Shaparov  1   2
Affiliations
Multicenter Study

Prostatic Artery Embolization for Benign Prostatic Hyperplasia Treatment: A Russian Multicenter Study in More Than 1,000 Treated Patients

Armais Kamalov et al. Am J Mens Health. 2020 May-Jun.

Abstract

Benign prostatic hyperplasia (BPH) is one of the most common diseases of the genitourinary system. The prevalence of BPH increases in men with advancing age. While transurethral resection of the prostate gland entails complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck sclerosis, and other adverse events, it is necessary to apply minimally invasive surgical methods such as superselective embolization of the prostatic arteries (PAE), particularly Proximal Embolization First Then Distal Embolization (PErFecTED). The data from 1,015 BPH patients who underwent endovascular surgery demonstrate the benefits of PErFecTED treatment during 24 months after surgery. Both Quality of Life score and International Prostate Symptom Score were around three times better in the PErFecTED group and remained stable during the entire observation period. However, the technique needs to be improved due to the high risk of postembolization syndrome.

Keywords: BPH; PAE; embolization; minimally invasive surgical methods; superselective embolization of prostatic arteries.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Options for the anatomy of the prostatic arteries: (1) a.prostatica from a.pudenda interna, (2) a.prostatica from a.vesicalis inferior, (3) a.prostatica from a.glutea inferior, (4) a.prostatica from a.rectalis media, (5) a.prostatica from a.obturatoria, (6) a.prostatica from a.glutea superior, and (7) a.prostatica from a.vesicalis superior.
Figure 2.
Figure 2.
Left (1) and right (2) prostatic arteries.
Figure 3.
Figure 3.
Anastomoses of the prostatic artery with various branches of the internal iliac arteries (scheme): with a.dorsalis penis, a.pudenda interna, a.rectalis media, and a.vesicalis inferior.
Figure 4.
Figure 4.
Anastomosis of the PA with the a. vesicalis inferior (1). Superselective catheterization of PA (2). PA = prostatic artery.
Figure 5.
Figure 5.
Identification of anastomosis of the prostatic and rectal arteries after the first stage of PAE. PAE = prostatic artery embolization.
Figure 6.
Figure 6.
Inadvertent embolization of the anastomosis of the prostatic artery (1) with the arteries of the penis (a.dorsalis penis) (2). Violation of trophism of the glans penis (3).
See this image and copyright information in PMC

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