Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery.
INTRODUCTION
Benign prostatic hyperplasia is considered the most frequent cause of lower urinary tract symptoms. Urinary catheterization is the emergency treatment for patients with urinary retention and surgery is indicated in patients refractory to medical treatment. There is a group of people with important comorbidities that make them ineligible for surgery. Prostatic arterial embolization (PAE) could be presented as a safe and effective alternative to achieve bladder emptying and spontaneous urination, thus avoiding permanent urinary catheterization in patients with significant comorbidities that represent a contraindication for surgery. In this retrospective study, we evaluated the efficacy of PAE in patients with permanent urinary catheterization who are ineligible for surgical treatment.


MATERIAL AND METHODS
Retrospective study of 26 patients with permanent urinary catheter who underwent prostatic embolization. Demographic and clinical data (age, use of anticoagulation, prostate volume, length of hospital stay, unilateral or bilateral embolization), Charlson comorbidity index evaluation and Clavien-Dindo classification for procedural complications were reviewed. Successful removal of permanent urinary catheter was analyzed at one month after the procedure.


RESULTS
A total of 26 patients were included in the review. The median age was 85 years with a median prostate volume of 90 mL. A Charlson comorbidity score above 7 was obtained in 88.5% of the subjects. Only one patient had one Clavien-Dindo III complication. Of the 26 subjects, 17 (65.4%) had spontaneous micturition and a postvoid residual lower than 100 mL at one month post procedure. Overall, catheter removal was achieved in 19 out of 26 subjects (73.1%).


CONCLUSION
PAE is a safe and effective treatment for patients with permanent urinary catheterization who are ineligible for surgical treatment.
['Salvador Hidalgo|D|D|', 'Bernardello Ureta|M|M|', 'Sbriglio|M|M|', 'García Gámez|A|A|', 'Sampere Moragas|J|J|', 'Areal Calama|J|J|', 'Ágreda Castañeda|F|F|']
D000369:Aged, 80 and over D001158:Arteries D004621:Embolization, Therapeutic D006801:Humans D008297:Male D011470:Prostatic Hyperplasia D012189:Retrospective Studies D062885:Urinary Catheters
Benign prostatic hyperplasia Lower urinary tract symptoms Prostatic embolization Benign prostatic hyperplasia treatment Embolización prostática Hiperplasia prostática benigna Síntomas del tracto urinario inferior Tratamiento de hiperplasia benigna de próstata