Selective embolisation for intractable bladder haemorrhages: A systematic review of the literature
Diaa-Eldin Taha1, Ahmed A Shokeir2, Omar A Aboumarzouk3
1Department of Urology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Insights
Selective transarterial embolisation (STE) effectively controls intractable bladder haemorrhage (IBH). This minimally invasive procedure offers a safe alternative for managing severe bleeding, particularly in patients with pelvic malignancies.
Area of Science:
- Interventional Radiology
- Urology
- Vascular Surgery
Background:
- Intractable bladder haemorrhage (IBH) presents a significant clinical challenge.
- Existing treatments for IBH may have limitations or significant side effects.
- Selective transarterial embolisation (STE) has emerged as a potential therapeutic option.
Purpose of the Study:
- To systematically review the current evidence on selective transarterial embolisation (STE) for intractable bladder haemorrhage (IBH).
- To assess the overall effectiveness of STE in controlling severe bladder bleeding.
- To evaluate the safety profile and identify potential complications associated with STE.
Main Methods:
- A systematic literature review was conducted following Cochrane guidelines and PRISMA checklist.
- Included studies were observational cohort studies published between 1978 and 2016.
- Data from 295 patients (age 51-95 years) were analyzed.
Main Results:
- The success rate of STE in controlling IBH ranged widely from 43% to 100%.
- Post-embolisation syndrome was the most frequently reported complication.
- Other described complications included mild transient gluteal claudication, nausea, and vomiting.
Conclusions:
- Selective transarterial embolisation (STE) of the internal iliac artery is a safe and effective treatment for severe intractable bladder haemorrhage (IBH).
- STE has a proven track record in managing bladder bleeding, especially in cases associated with terminal pelvic malignancy.
- The procedure represents a valuable alternative technique for controlling life-threatening bladder haemorrhage.
Objective:
To establish the current evidence and assess the effectiveness and safety of selective transarterial embolisation (STE) to control intractable bladder haemorrhage (IBH).
Materials And Methods:
With a rise in the use of STE for the treatment of IBH, a systematic review was performed according to the Cochrane reviews guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.
Results:
The literature search yielded 38 studies, of which 11 were excluded because of irrelevance of data. All included studies were observational cohort studies, with no randomisation or control groups apart from in relation to the materials used for embolisation. The studies were published between 1978 and 2016. There were 295 patients with an age range between 51 and 95 years. The success rate ranged from 43% up to 100%. The most reported complication was post-embolisation syndrome, although other complications were described such as mild transient gluteal claudication, nausea, and vomiting.
Conclusion:
STE of the internal iliac artery is a safe and effective alternative technique to control severe IBH, and has been successfully applied over many years to treat bladder haemorrhage associated with terminal pelvic malignancy.
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