Effectiveness Of Super-selective Prostatic Artery Embolization In The Treatment Of Ultra-large Benign Prostatic Hyperplasia

Objective:To investigate the feasibility and clinical efficacy of super-selective prostatic artery embolization(PAE)in the treatment of ultra-large(≥120ml)benign prostatic hyperplasia.Methods:A retrospective analysis was used to collect the clinical data of 18 patients with ultra-large(≥ 120ml)benign prostatic hyperplasia treated with super-selective prostatic artery embolization at the First Hospital of Shanxi Medical University from August 2018 to December 2019,comparing the patients’ prostate volume(PV),international prostate symptom score(IPSS),quality of life score(Qo L)at 1,3 and 6 months after surgery with those before surgery.The differences in the prostate volume(PV),prostate symptom score(IPSS),quality of life score(Qo L),maximum urinary flow rate(Qmax)and residual urine volume(RUV),the perioperative indicators such as the duration of surgery and the duration of indwelling catheter,and the occurrence of postoperative surgery-related complications were observed to analyze and evaluate the feasibility and clinical efficacy of this surgical procedure.Results:All patients with benign prostatic hyperplasia successfully completed PAE.Among them,1 case only underwent unilateral prostatic artery embolization due to severe atherosclerosis of one side of the prostate because the microcatheter could not pass,and 17 cases underwent bilateral prostatic artery embolization.The operation time for 18 cases of PAE was 95 to 190 minutes,and the median operation time was 130 minutes.After the operation,4 cases developed mild pain in the pubic area and burning sensation in the urethra,2 cases developed transient hematuria,3 cases developed fever symptoms,and 12 cases successfully removed the urinary catheter on the third day after the operation.Urinating spontaneously,the removal of the catheter in the remaining 6 patients was 10 to17 days after surgery,and no serious complications occurred in all patients.The patients’ PV,IPSS,Qo L and RUV were significantly lower than those before operation at 1,3 and 6months postoperative follow-up,and Qmax was significantly higher than before operation,the difference was statistically significant(P<0.05).Conclusion:The procedure of super-selective prostatic artery embolization for the treatment of ultra-large benign prostatic hyperplasia has a definite surgical effect and high safety.It has certain clinical application prospects.It can be used as one of the alternative surgical methods for the clinical treatment of benign prostatic hyperplasia.The author believes that patients with benign prostatic hyperplasia whose prostate volume is more than 120 ml,the elderly,and many underlying diseases are not suitable for conventional anesthesia surgery are more recommended to choose PAE as a minimally invasive treatment.