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Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It

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Abstract

Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.

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Acknowledgments

The authors thank Joaquim Mauricio da Motta-Leal-Filho, Eduardo Muracca Yoshinaga, Vanessa Cristina de Paula Rodrigues, Airton Mota Moreira, Octavio Meneghelli Galvão Gonçalves, Andre Moreira de Assis, Ronaldo Hueb Baroni, Antonio Sergio Zafred Marcelino, Luciana Mendes de Oliveira Cerri, Miguel Srougi and Giovanni Guido Cerri for their important collaboration.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Interventional Radiology Unit, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-001, Brazil

    Francisco C. Carnevale

  2. Division of Urology, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-001, Brazil

    Alberto A. Antunes

  3. Rua Teodoro Sampaio, 352/17, 05406-000, São Paulo, Brazil

    Francisco C. Carnevale

Authors
  1. Francisco C. Carnevale
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  2. Alberto A. Antunes
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Correspondence to Francisco C. Carnevale.

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Carnevale, F.C., Antunes, A.A. Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It. Cardiovasc Intervent Radiol 36, 1452–1463 (2013). https://doi.org/10.1007/s00270-013-0680-5

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  • DOI: https://doi.org/10.1007/s00270-013-0680-5

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