Arterial embolization in the therapy of prostatic hyperplasia (a report of 12 case)

Objective: To evaluate the efficacy of arterial embolization in the therapy of benign prostatic hyperplasia (BHP). Methods: After super-selective arterial contrast medium administration and comfirmation of prostate blood-supply artery, polyvinyl alcohol (PYA) and gelfoam were injected via the arterial catheter in 12 patients diagnosed as BHP. Pre-and post-operative I-PSS, quality of life (QOL), maximum urine flow rate (Qmax), and residual urine (RU) were compared. At the same time, the changes of prostate volume and blood supply were evaluated by endorectal ultrasound and CT. The change of urethral diameter was also evaluated by urethral contrast medium. Results: A total of 21 prostate blood-supply arteries were embolized, including 5 internal iliac arteries, 9 inferior vesical arteries, 5 internal pudendal arteries, and 2 obturator arteries. Bilateral arterial embolization was performed in 9 patients and unilateral embolization was performed in 3 patients. The post-operative I-PSS (4.8), QOL(1.3), Qmax (18.9 ml/s), and RU (3 ml) were obviously improved compared with those of pre-operation (24.2, 4.8, 9.6 ml/s, and 138 ml). The prostate blood supply was obviously decreased and the maximum speed of blood stream was slackened from (19.3±9.8) cm/s to (10.0±8.9) cm/s. The prostate volume decreased from pre-operative 127.6 ml to post-operative 65.1 ml. The reduction rate was 51%. Conclusion: The arterial embolization in the therapy of BHP was a new method. It had some advantages, such as less injury, higher efficacy, better safety and fewer complications. (authors)