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The application of prostate artery embolization in the management of intractable prostate bleeding
Agata Stężewska1, Magdalena Stężewska1, Bartosz Żabicki2
1Department of Urology, Collegium Medicum, University of Zielona Góra, Zielona Góra, Poland.
Insights
Prostate artery embolization (PAE) is a safe and effective treatment for refractory bleeding in advanced prostate cancer patients, offering clinical success with low complication rates.
Area of Science:
- Urology
- Interventional Radiology
- Oncology
Background:
- Prostate cancer is a prevalent malignancy in European men.
- Advanced stages often lead to refractory bleeding, posing challenges for elderly or debilitated patients.
- Traditional invasive procedures may not be suitable for all patients.
Purpose of the Study:
- To review the outcomes of prostate artery embolization (PAE) for managing refractory bleeding in prostate cancer.
- To evaluate the safety and efficacy of PAE in this patient population.
Main Methods:
- A systematic literature search of PubMed for English-language articles (2003-2019) on PAE in prostate cancer.
- Analysis of studies focusing on patient demographics, bleeding etiology, procedural details, embolic agents, success rates, complications, and recurrence.
- Review included 10 original full-text studies (comparative and case series).
Main Results:
- PAE demonstrated technical and clinical success in treating refractory bleeding and associated lower urinary tract symptoms.
- Minor complications were reported in 10-50% of cases.
- Recurrence of hematuria was observed in 10-57% of patients post-procedure.
Conclusions:
- Prostate artery embolization is a safe procedure with a low risk of complications for managing prostate cancer-related hemorrhage.
- PAE is a promising treatment option for eligible patients, though further research is warranted due to limited data.
Introduction:
Prostate cancer is one of the most common malignancies affecting European men. Sequelae of the advanced malignancy require invasive procedures which may not be eligible especially for old, debilitated patients. The aim of this manuscript is to review the outcomes of prostate artery embolization in the management of refractory bleeding.
Material And Methods:
A PubMed database search was done for all English language articles on prostate artery embolization in prostate cancer, published between 2003 and 2019. For current review, information related to number, age of the patients, aetiology of the hematuria, bilateral or unilateral procedure, type of embolic material, technical and clinical success, complications, recurrent hematuria, hematocrit and hemoglobin levels were analyzed.
Results:
A total of 10 original full-text comparative and non-comparative (case series) studies were reviewed. Minor complications described in the literature ranged from 10-50%. After prostate artery embolization, the recurrence of the haematuria occurred in 10-57% of the patients. Moreover, prostate artery embolization successfully treated lower urinary tract symptoms and urinary retention in prostate cancer patients.
Conclusions:
The procedure appears safe, burdened with low risk of complications and accomplishes technical and clinical success. It is a promising option for patients with hemorrhage, but due to the scarcity of data further investigations are needed.
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