Role of transcatheter arterial embolization in the management of refractory hematuria of prostatic origin

Objective: To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods: This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0 ± 7.5 years, range 58 to 84 years) who underwent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results: Of the 31 patients, 6 patients (19.4%) were with active bleeding, 4 (12.9%) with aneurysm and 27 (87.1%) with abnormal neovascularization on the angiogram. The 31 patients underwent a tattle of 37 TAE, the technical success rate was 100.0% (37/37) and the recent hemostasis success rate was 90.3% (28/31). The incidence of mild complications was 38.7% (13/31), there was no serious complication associated with TAE. Conclusion: TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin. (authors)