Intractable hematuria due to giant prostatic hyperplasia effectively treated with prostatic artery embolization

Area of Science:

• Urology
• Interventional Radiology

Background:

• Giant prostatic hyperplasia (GPH) is a rare condition.
• Traditional treatment involves open suprapubic prostatectomy, which carries significant risks, including fatal hemorrhage.
• Patients with GPH often have diminished renal function due to obstructive nephropathy, complicating treatment choices.

Observation:

• A patient with GPH presented with intractable hematuria and compromised renal function.
• The patient was deemed unfit for conventional endovascular therapies requiring traditional contrast agents.

Findings:

• The patient underwent successful prostatic artery embolization (PAE).
• Carbon dioxide (CO2) digital subtraction arteriography was utilized as a contrast agent, avoiding iodinated contrast media.
• This approach successfully managed the hematuria and preserved renal function.

Implications:

• PAE with CO2 angiography is a viable and potentially safer alternative for treating GPH in patients with renal insufficiency.
• This technique expands endovascular treatment options for complex GPH cases.
• Further research into CO2 angiography for PAE in similar patient populations is warranted.