Embolization of prostate arteries: procedure technique

Modern surgical methods for treating prostate adenoma are improving every day. Embolization of prostate arteries has been widely used in Russia for about 10 years. This procedure is a minimally invasive procedure and should be performed by a highly trained physician experienced in intravascular surgery. The operation makes it possible to achieve remission of the adenoma, but for this it is necessary to strictly adhere to the rules during the rehabilitation period.

BPH

Prostate adenoma is a benign formation in the prostate gland. The reasons for its appearance in most cases lie in changes in the balance of hormones. This process is typical for men 50-55 years old.

It is at this age that the concentration of sex hormones begins to gradually fall, and estrogen and estradiol begin to increase. These hormones promote the growth of adenoma.

Doctors distinguish 3 stages of the disease. Conservative treatment is indicated in the first stage; the next two require surgical intervention. In advanced cases of the disease, the prostate must be removed.

Symptoms of prostate adenoma:

• Constant urge to urinate. Even immediately after visiting the toilet, the patient again experiences the urge. The sensation worsens at night;
• Sluggish stream. In order to urinate, a man has to keep his abdominal muscles under strong tension. Despite increased efforts, the feeling of a full bladder remains;
• Burning and itching in the urinary tract;
• Problems with potency. Sexual desire is greatly reduced, up to complete impotence;
• Presence of blood in urine and semen. This sign indicates that the pathology is getting worse;
• Pain in the groin area that occurs during sexual intercourse and the process of urination.

If treatment for adenoma is not started in time, the patient’s condition will quickly begin to deteriorate. Urinary retention accumulates, the patient’s sensations are characteristic of a state of severe poisoning.

Indications for embolization

Embolization of the prostate arteries is designed to restore prostate function. The operation is indicated in cases where the tumor is benign and the total size of the prostate and tumor does not exceed 80 cm3.

Embolization is also successfully used for prostate cancer, combating the consequences of mechanical injuries to the gland, and varicose veins.

The operation is indicated for rupture of the blood vessels supplying the prostate.

Embolization is not a panacea and cannot be used in some cases. Thus, in case of adenoma anomalies and in case of vascular obstruction, it is strictly contraindicated. If there is a risk of thrombus rupture, embolization is also strictly prohibited.

Preparation

Embolization of prostate adenoma is always preceded by a set of diagnostic measures. Tests that need to be done before the procedure:

• general urine and blood tests;
• blood sugar test;
• Ultrasound of veins in the legs;
• ECG.

The urologist necessarily conducts a digital examination of the prostate and does a blood test for tumor markers.

Having all the examination results in hand, the doctor decides whether it is advisable to perform embolization or whether other treatment methods are indicated for the patient.

No special preparation is required for the procedure. It is enough just to cleanly shave the hair in the groin and not eat 4 hours before the operation. Drinking water is allowed, but in small quantities.

Carrying out the procedure

If necessary, the patient takes prescribed antibiotics before embolization. Immediately before embolization, the surgeon injects a sedative for anesthesia intramuscularly and then inserts a catheter.

Prostate embolization is performed as follows:

1. The patient is placed on the operating table. Sensors are attached to his chest to take ECG data. A wrist cuff helps monitor pressure fluctuations. A blood oxygen sensor is attached to the patient's finger.
2. A puncture is made on the right thigh a few centimeters from the groin and the surgeon begins arteriography.
3. The doctor then finds the arteries leading to the prostate gland and inserts a microcatheter with a diameter of less than 1 millimeter into them.
4. The surgeon localizes the location of the catheter in the artery, then delivers a special drug through it. It consists of microscopic round-shaped pieces of medical plastic.
5. After administration of the embolization drug, a control examination of the vessels is performed. It serves as confirmation that the arteries supplying the prostate are well blocked.

After the operation, the doctor applies special pressure to the puncture site in the thigh to avoid the formation of a hematoma. The entire procedure takes from half an hour to an hour, depending on its course.

Postoperative period

X-ray endovascular embolization of prostate arteries leads to a reduction in the size of the adenoma by 60-80%. The prostate gland itself also shrinks in size by 50% or more. Thanks to this effect, the process of urination returns to normal.

The positive effect of the procedure makes itself felt within 3-4 days. The frequent painful urge to urinate stops, the person gets rid of constant pain in the groin and other unpleasant sensations.

The vast majority of patients note that the embolization procedure has significantly improved their quality of life. A person not only gets rid of constant discomfort, but also regains confidence in his own potency quite quickly.

It is necessary to spend 2-3 days in the hospital for complete recovery.

Prevention

In order to exclude further relapses of prostate adenoma, it is enough to follow simple rules:

• Go to a urologist regularly for examination. You must take all tests prescribed by your doctor to monitor your prostate. Do not think that after surgery the adenoma cannot return again;
• Eat properly. In addition to the basic rules of a healthy diet, patients after embolization should avoid foods high in fat and simple carbohydrates;
• Eliminate alcohol from your diet. This recommendation especially applies to beer containing phytoestrogens. These hormones can trigger the growth of adenoma;
• Stop smoking, as this habit has a bad effect on the vascular system as a whole;
• Take medications containing hormones only as prescribed by your doctor and very carefully . Any change in hormonal balance can cause recurrence of adenoma;
• Exercise and try to maintain an active lifestyle. This especially applies to patients with sedentary work. They definitely need walks, which not only remove blood stagnation in the pelvic area, but also have a positive effect on the emotional sphere.

Are any medications needed after embolization of an adenoma to prevent its possible growth? Usually not needed unless there are special indications. These medications negatively affect potency and sperm quality, so their use for preventive purposes is not justified.

In the postoperative period, the doctor may prescribe dietary supplements for rapid healing and to avoid relapses of adenoma in the future.

As a rule, general recommendations on changing your lifestyle to a healthier one are quite enough to prevent prostate adenoma from returning.

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Source: https://MedProstatit.ru/embolizaciya-arterij-prostaty.html

Embolization of prostate vessels: what is it, indications, procedure, reviews

Embolization of prostate vessels is a selective blockage (occlusion) of blood arteries with special substances, emboli. Limits blood flow to the organ, which helps to reduce it.

Minimally invasive x-ray endovascular surgery, performed routinely according to indications.

A new effective method for treating prostate adenoma, which makes it possible to reduce its size by a third and achieve stable remission.

Indications for use 

The indication for the procedure is prostate adenoma (benign hyperplasia), accompanied by urination problems. Blocking of blood collaterals is resorted to mainly in the absence of improvement after drug treatment. Arterial embolization for BPH will be performed in the following cases:

• increase in prostate volume more than 60 cm³;
• obstructive urination disorders;
• large volume of residual urine in the urinary tract;
• pain and cramps associated with BPH; 
• injuries n.g. with ruptures of blood vessels;  
• ineffectiveness of drug therapy;
• bleeding disorders;
• the need to restore urination in patients with cystostomy;
• varicose veins of prostatic veins with bleeding;
• contraindications to TUR operation.

Carrying out prostate embolization at stages 1–2 of hyperplasia significantly increases the effectiveness of the event. Improvements in the treatment of prostate adenoma can be achieved in 90–95% of cases.

Later stages of the disease slightly reduce the success of the manipulation. In general, the prognosis is favorable, 90 out of 100 patients after prostate embolization note relief of symptoms, the pathology goes into stable remission.

Preparatory stage 

Embolization of prostate vessels is performed on the day of hospitalization. The minimally invasive intervention is performed under local anesthesia after diagnosis. The examination includes:

• electrocardiography (ECG);
• general urine and blood tests;
• biochemical blood testing;
• RV, HIV, hepatitis B, C tests;
• chest x-ray;
• determination of PSA indicators;
• TRUS of the prostate, uroflowmetry;
• CT angiography of the pelvic organs.

Arterial embolization is a surgical procedure involving penetration into a vessel by breaking the integrity of the skin. Before the operation, the surgical field is prepared - the hair in the groin area is shaved. It is recommended to refrain from eating 4 hours before anesthesia; a little water is allowed.

Ask a urologist a question!

Kolokolov V.N.

To exclude the development of inflammation, a course of antibiotics is prescribed before embolization of the prostate. The patient is given premedication - painkillers, sedatives, and sometimes antihistamines are injected intramuscularly. This is necessary to reduce the pain threshold and anxiety. A urinary catheter is installed during the operation and for 4–5 hours after it.

Progress of the operation 

Prostate artery embolization (PAE) is carried out in a radiology operating room equipped with an angiographic complex that provides an accurate image in the present time period.

It is performed by an x-ray endovascular surgeon.

The procedure requires skills in endoscopic manipulation of extremely small vessels (less than 1 mm) and the ability to coordinate their actions using an X-ray angiography unit.

The operation is carried out under the visual supervision of a specialist using an angiograph in several stages. The insertion of a catheter into the vessel is preceded by local anesthesia: the area of ​​the femoral artery is injected with a local anesthetic. Prostate embolization algorithm:

1. A puncture is made in the skin below the inguinal fold.
2. The sources of blood supply to the prostate are determined (angiography).
3. A microcatheter with a contrast agent is inserted into the desired vessel.
4. An embolization drug is injected into the vessel through a catheter.
5. A control re-contrast is performed.
6. The catheter is removed and a pressure bandage is applied.
7. The puncture site is treated and sealed with adhesive tape.
8. The patient is transferred to the ward and can get up after 6 hours.

During the operation, blood pressure, respiratory rate and pulse are monitored. Special sensors installed on the body determine the amount of oxygen in the peripheral parts. A special brand of inert, freely compressible medical plastic is used as an embolic agent.

The average duration of the procedure is up to 3–5 hours. Modern endovascular catheters allow embolization of two arteries (right and left) simultaneously with one puncture.  

Contraindications and consequences 

Embolization of prostatic arteries is a fairly safe procedure, but, unfortunately, it is not indicated for everyone. Contraindications to the procedure are:

• pathologies and anomalies of the iliac vessels;
• blockage of the iliac vessels by blood clots;
• embolic thrombi in the veins of the lower body;
• renal and respiratory failure in severe form;
• allergy to iodine (included in radiocontrast agent).

Any surgery, including minimally invasive surgery, has certain risks. Possible complications of prostate artery embolization:

• hemorrhages at the puncture site (5% of cases);
• nausea, weakness, slight discomfort;
• bleeding from a vessel;
• short-term disturbance of urination (rare);
• pain in the groin, perineum, numbness of the skin near the puncture.

The consequences are usually short-term and go away on their own. The success of embolization does not depend on prostate parameters. If there is a further need for classical surgery, occlusion of the prostatic vessels reduces the risk of bleeding.

Rehabilitation period 

Embolization of the prostate arteries is relatively easy to tolerate. After surgery, your lower abdomen may feel slightly sore for several hours.

This is a natural reaction to a sharp decrease in blood supply to the organ and the formation of infarct zones in the adenoma. The full rehabilitation period takes up to one and a half months. Observation in hospital – up to 3 days.

The catheter is removed after 10–12 days; while it is in place, slight discomfort is observed that does not reduce the quality of life.

With normal recovery, the patient is ambulating and self-care the day after surgery. The appearance of a slight fever and bloody discharge in the urine on days 1–3 is associated with necrotic phenomena; this is a consequence of embolism.

During this period, the patient must be in the hospital. Recommendations after EAP:  

• regular observation by a specialist;
• Ultrasound (TRUS) every 3 months;
• control of prostatic antigen levels;
• nutritious nutrition; 
• normalization of lifestyle;
• complete cessation of alcohol and smoking;
• exclusion of drugs that provoke the growth of adenoma. 

Reviews 

I agreed to embolization and did not regret it. The procedure is quick and painless. The temperature lasted for a couple of days, but this is normal. The symptoms disappeared after two weeks, urination returned to normal, and I no longer run at night. It cost 80 thousand rubles for the procedure, plus the price for a bottle of the drug - 20 thousand.

Yuri, 58 years old, Izhevsk

Embolization came out to 100 thousand with the medicine. In my case, this was the only result of curing my huge adenoma with “little blood.” After a month and a half, in addition to the disappearance of problems with urination, I noticed an improvement “like a man,” desire appeared, and potency increased.

Ivan, 52 years old, Tomsk

I treated the adenoma for a long time - pills, laser, nothing helped. The doctor recommended embolization and prepared for the operation for two months. The cause was inflammation in the prostate. There is a high ESR and leukocytosis in the blood, and urine tests are also not very good. I took a course of antibiotics and had surgery. Now I’m healthy, I passed the PSA test - the result dropped by almost half.

Yuri, 66 years old, Divnogorsk

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Source: https://mprostata.com/lechenie/ehmbolizaciya-sosudov-prostaty

Embolization of prostate arteries: procedure technique and treatment results

Embolization is thrombosis of the blood vessels of the pelvic organs, during which the blood supply is stopped or reduced to a lesser extent, and the prostate increases in size and the gland decreases. The intervention has been carried out by trained specialists since 2010. However, in modern medicine, embolization of prostate arteries is rarely performed and not in all clinics due to the insufficient number of trained specialists.

Important! The use of medications stops the inflammatory process. If the disease is diagnosed late, treatment may not give a positive result.

In order not to subject the patient to surgical intervention, embolization of the prostate arteries is performed for medical reasons.

Positive aspects of the procedure

Having carried out numerous procedures, experts noted a number of positive qualities:

1. Embolization of the prostate arteries is performed on an outpatient basis. Patients do not have to go to the hospital for the procedure.
2. During planned hospitalization, a man with positive dynamics and no complications is discharged no later than 24 hours after the manipulation.
3. The procedure does not cause serious complications.
4. The rehabilitation period takes place at home and does not require much effort. The integrity of the skin is restored without suturing, which eliminates the need for a number of aseptic measures.
5. The patient feels well after embolization. He can go to the toilet and dress himself without assistance.
6. After the manipulation there is no need to change the dressing material.

Complications during arterial embolization are extremely rare. Usually appear locally.

Indications for manipulation

X-ray endovascular arterial embolization is not performed in all patients, strictly according to individual indications:

1. During the inflammatory process, when prostatitis increases in size and becomes more than eighty cubic centimeters.
2. Varicose veins when simultaneously diagnosed with prostate adenoma. Possible bleeding that cannot be stopped with medications.
3. Concomitant diseases that are a contraindication to the use of many medications to cope with inflammation of the prostate gland, such as: disorders of the cardiovascular system and gastrointestinal tract. Chronic kidney and liver diseases, poor blood clotting, diabetes of any degree.
4. Ineffectiveness of a previously performed procedure - cystostomy.
5. Malignant neoplasm of the prostate gland.
6. Injury to the prostate or other pelvic organs and genitourinary system.
7. Rupture of the vessels that supply blood to the prostate and supply it with essential microelements.

Contraindications to embolization of prostate arteries

Despite a number of positive qualities of the procedure, for medical reasons it is contraindicated for some patients.

Complications in the male body that do not allow embolization:

1. Pulmonary embolism or other blood clots present in a man and which can break off during manipulation, which will lead to the death of the patient.
2. Abnormal anatomical structure of the iliac vascular network.
3. Occlusion of the iliac vasculature.

Visiting a specialist and preparing for the procedure

After contacting a urologist, the doctor will collect an oral history. Prescribe clinical tests:

1. Taking a general urine test.
2. General blood test.
3. Blood for the presence of glucose.
4. Ultrasound of the venous network of the lower extremities.
5. Electrocardiogram of the heart.
6. Direct palpation of the prostate.

The patient must undergo a consultation with an anesthesiologist to select anesthesia, to exclude possible side effects from the administered drug. The man also visits a therapist three days before the procedure to rule out possible acute infections, which are unacceptable at the time of embolization of the prostate arteries.

Important! A week before the procedure, the attending specialist prescribes antibiotics.  

Patient preparation before manipulation includes:

• quitting smoking five days before the procedure;
• Abstaining from drinking alcohol;
• the patient is prohibited from having dinner the evening before embolization;
• a week before the procedure, a man should not eat large amounts of fatty and fried foods;
• the patient should reduce the consumption of citrus fruits that can thin the blood;
• a man is also prohibited from taking medications that affect the functioning of the circulatory system and from self-medicating, taking medications not prescribed by the attending physician;
• The patient must prepare for the procedure and shave the area from the nipples to the knees the evening before the procedure.

Progress of the procedure

In the morning on the specified day, the patient comes to the specialist on an outpatient basis. X-ray endovascular embolism of arteries for inflammation of the prostate gland is carried out in an office with the necessary equipment. The patient is placed on the couch. The doctor once again explains the upcoming procedure and takes verbal consent to perform it.

Progress of arterial embolization for prostatitis:

1.  The patient is given painkillers in the surgical area. Usually this is the area where the femoral artery is located, two centimeters lower than the inguinal fold.
2. A urinary catheter is installed.
3. When a contrast agent is injected into the vascular network, the man experiences a feeling of heat in the pelvic organs.
4. A tube is inserted into the urinary catheter through which the medication is administered. It was invented specifically for this procedure and consists of balls made of specialized plastic.

The procedure lasts from 50 minutes to 6 hours. The difficulty in its implementation lies in the problem of catheterization of small vessels. Therefore, not all specialists are in a hurry to undergo training and carry out this manipulation. If the vessels are catheterized incorrectly, a man may experience atherosclerosis, which will lead to new treatment and consequences.

After the operation, the specialist applies pressure with a finger to the puncture site (this is done to prevent the formation of complications) and applies a homeostatic bandage.

After prostate embolization, the patient may feel a nagging pain in the lower abdomen. This is a typical phenomenon that goes away on its own after a few days.

The result of the manipulation

The inflammatory process after embolization is reduced by 40%. Prostatic symptoms are noticeably reduced, and the man does not experience pain when urinating. When all the doctor’s prescriptions are followed, the disease stops progressing and recovery occurs.

Source: http://proprostatu.ru/lechenie/embolizatsiya-arterij-prostaty.html

What is prostate artery embolization?

Pathologies of the prostate gland are quite common and cause a lot of trouble for men.

Younger patients are characterized by the development of prostatic inflammation, and in adulthood, patients are more likely to experience gland hyperplasia and other changes in prostatic tissues, which can seriously affect a man’s future life and health.

Therefore, treatment is extremely important in such a situation. Drug therapy is often used to stop further progression of the pathology, and subsequently surgical intervention is prescribed, which is not necessarily associated with traumatic procedures.

 Prostate artery embolization (PAE) is a minimally invasive technique used to treat prostate adenoma. This method does not require a long hospital stay and has a short rehabilitation period.

Specifics of the procedure

So, embolization of the prostate arteries is one of the surgical methods for treating benign hyperplasia, which is carried out using endovascular techniques and fluoroscopic control. Such an intervention is an alternative method of adenoma removal and can only be carried out in specialized clinical medical institutions.

This is a minimally invasive intervention that can only be performed by highly qualified surgeons. In recent years, this technique has been actively introduced into the practice of surgical treatment of prostatic formations. The essence of EAP comes down to clogging the vessels that feed enlarged prostate tissue, which leads to a decrease in hyperplasia.

Such an operation is considered a full-fledged alternative method to such surgical procedures as removal of the gland or endoscopic transurethral resection.

This is a relatively young technique, which today is considered generally accepted and a priority in the treatment of adenoma and more.

Indications for testing

The use of prostate embolization is indicated in the treatment of symptomatic hyperplasia of glandular tissues. But the specialist must conduct a comprehensive examination in order to exclude other causes of the appearance of such symptoms, as well as the presence of other prostatic pathologies that cannot be treated with EAP. In addition, this intervention is indicated:

• If hyperplasia exceeds 80 cm3;
• In the presence of concomitant pathologies of the cardiovascular system of a severe nature (including heart attacks), kidney diseases, bleeding disorders or diabetes;
• Existing cystostomy;
• Varicose veins, complicated by bleeding from dilated prostatic veins, which cannot be eliminated using traditional methods of treatment;
• Severe and intractable pain, a large amount of residual urine and excessively frequent urination - all this is also a direct indication for vascular embolization.

If hyperplastic changes in the prostate are at an early stage of development, then the effectiveness of a method such as x-ray endovascular arterial embolization reaches 95%. Over time, pathological changes invariably progress, and therefore the prognosis for an old adenoma worsens, reaching 87-90% effectiveness.

How to prepare

Embolization requires careful preparation and diagnosis of the disease. The man must undergo all laboratory tests (blood, urine, stool, sugar test, urethral smear, etc.).

The cardiovascular system is also thoroughly examined, an electrocardiogram and ultrasound examination of the blood vessels of the legs are performed.

It is also necessary to examine the prostate itself, for which the man is prescribed an ultrasound of the organ and a digital rectal examination.

To avoid unexpected adverse reactions during embolization, the patient is tested for hypersensitivity to anesthetic drugs.

If malignant processes are suspected, surgical intervention is preceded by a mandatory prostate biopsy and a study of the level of PSA, a prostatic agent. Before the operation (12 hours before) it is forbidden to eat, you can only drink water without restrictions.

Before the intervention, the patient is given an enema to cleanse the intestines, and the anterior thigh area and groin are removed from hair.

Premedication is also carried out, which involves taking sedatives, which are necessary to reduce psycho-emotional tension and anxiety, stress conditions and excitability before the procedure.

If any complications arise during the operation, symptomatic therapy is prescribed.

Before the intervention, the man must have a catheter inserted to ensure unimpeded urinary flow during the operation.

The man is placed on the operating table and put on all the necessary equipment that will record the patient’s vital signs. He is given anesthesia, numbing the required area with specialized drugs.

If the patient is an elderly man, then the prostate vessels are embolized using oxygen supply equipment.

Technique

Surgeons perform surgical endovascular intervention through a small incision made in the groin area.

1. A special catheter is carefully inserted into the lumen of the femoral artery, from where it is directed into the small vascular passages of the prostate.
2. So the catheter is brought to the vessel feeding the adenomatous tissue.
3. The specialist clogs it with special microparticles, which are fed through a catheter - emboli. They create an obstruction to blood flow.
4. Similar actions are carried out on the other side of the gland, which ensures blocking of the blood supply to the gland on both sides.
5. As a result, the embolized arteries stop delivering the necessary nutrition to the affected tissues, which leads to a decrease in the size of the adenoma.
6. The procedure lasts about 1-4 hours, depending on the degree of prostate damage.

As a result of the intervention, blood flow to the gland is disrupted, and in those areas where the emboli have reached, tissue death and necrosis begin.

 Surgeons warn that it is impossible to completely paralyze blood circulation in the prostate with such an intervention, so the gland does not die completely, but continues to function.

Against the background of necrosis of some of its zones, hypoplastic tissues soften, which leads to the restoration of urinary functions. After about 4 months, the dead tissue is replaced by scar tissue, and after six months the size of the gland decreases by 30-40%.

Rehabilitation and outcome of surgery

Patients tolerate this intervention quite easily. The operation is generally painless and is therefore performed under local anesthesia or anesthesia.

Some patients report discomfort associated with prolonged stays in a stationary position, lying on their back.

After about 4 days, the patient is discharged home, but for 10 days it is necessary to take antibiotics and NSAIDs to prevent postoperative complications. In the first 24 hours, men may feel some discomfort and slight pressure on the groin area.

If the blood supply to one artery is blocked, then the surgical intervention is already considered successful; a similar result is observed after 95% of operations.

Improvement in the patient's condition becomes noticeable approximately 2-3 days after embolization. After 1, 3 and 6 months, the patient undergoes an ultrasound examination.

In approximately 10 patients out of a hundred, signs of pathology return again, then the patient undergoes repeated EAP.

Possible complications

Arterial embolization is considered a relatively safe procedure that effectively deals with prostatic adenoma, and there are practically no complications after EAP. Although in some cases it is possible to develop hematuria, hemospermia, or a hematoma at the puncture site.

Such complications occur relatively infrequently, but they go away quite quickly on their own.

Therefore, today, X-ray endovascular embolization of prostatic vessels is considered the safest and most effective way to treat benign prostatic hyperplasia.

Contraindications

For the treatment of adenoma by vascular embolization, there are several contraindications due to the general health of the patient. In order to promptly identify these conditions, such thorough preoperative preparation is carried out. The most striking contraindications for embolization are:

• Occlusive vascular lesions that need to be embolized;
• Some anomalies in the structure of the iliac vessels;
• The presence of blood clots in the venous channels of the extremities;
• Intolerance to iodine-based drugs;
• Problems with blood clotting;
• Malignant tumors in prostatic tissues;
• Increased creatinine levels;
• The patient's medical history is aggravated by coagulopathy.

Of no small importance is the patient’s age, the presence of concomitant pathologies, urinary dysfunction, genitourinary infections, etc. The decision to use embolization is made by a whole council of specialists based on the diagnostic results obtained, and such specialists as an endovascular surgeon and a urologist must be present in the council.

Forecasts and benefits of EAP

As a result of embolization, according to experts, it provides a fairly high therapeutic effect and lasting results. Many scientists have repeatedly proven the effectiveness of EAP, having written many works on this topic. Within a year, after embolization in men, the affected prostate tissue noticeably decreased, coupled with regression of adenoma symptoms.

How quickly improvements in health will develop depends on bad habits and the rhythm of life. After some time, in approximately 99% of cases, sexual functions are completely normalized and urinary flow is restored. In a third of patients, the volume of the gland steadily decreases within a month after surgery.

Embolization of prostatic arteries has many advantages over other treatment methods.

Firstly, EAP is characterized by a high therapeutic effect and the minimum possible invasiveness, because for the operation only a small puncture is made to insert a catheter.

In addition, when performing embolization, there is no need to use general anesthesia; local anesthesia is sufficient, because the procedure is virtually painless.

Another undoubted advantage is that EAP is indicated for any size of glandular organ. Secondly, postoperative rehabilitation is painless and takes a fairly short period of time. And thirdly, the technique is suitable for patients who have some severe concomitant complications.

After the procedure, to confirm that all vascular channels of the prostate are reliably blocked, specialists perform a control contrast. The procedure has received worthy recognition among specialists. There are two major international research studies that have indisputably proven the effectiveness of embolization in the treatment of prostate adenoma. The prostate gland begins to shrink in the first week in a third of patients, due to which the unpleasant symptoms of adenoma associated with urinary dysfunction and pain disappear. Then, within a year, urodynamic processes are finally restored.

Source: https://DlyaMuzhikov.ru/prostate/embolizatsiya-arterij-prostaty.html

Embolization of prostate arteries - technique, indications and effect

Embolization of prostate arteries is a modern method of treating adenoma and hyperplasia of prostate tissue. This is a low-traumatic procedure in which the doctor places special balls into the lumen of the vessels feeding the tumor. Because of this, blood circulation is impaired, and the tissue is destroyed and dissolved over time.

Please note that this method of treatment is suitable for use only in the initial stages of the disease. It is not used if there is at least one contraindication. Embolization takes place as planned, and before the intervention the patient is sent for an extensive medical examination.

Advantages of technology

Embolization of prostate arteries is a low-traumatic method of treating adenoma and prostatitis. This method is being used more and more often.

Doctors themselves send their patients to this procedure, as it is quite safe and highly effective. The operation was previously performed exclusively in a hospital setting, but now it can also be performed on an outpatient basis.

Another advantage of prostate artery embolization is the complete absence of sutures on the skin; you will not need to process them and regularly check the healing rate.

Subsequently, you will not encounter painful sensations, which will not distract you from your business. Due to the absence of incisions, there is no need for dressings or intensive care. The procedure is completely safe, complications and negative consequences are extremely rare.

Indications and contraindications

Typically, prostate artery embolization is used in the following cases:

• For prostate injuries;
• For prostate cancer;
• When blood vessels in the prostate gland rupture;
• For benign hyperplasia;
• In the presence of aggravating diagnoses: heart attack, stroke, ischemia, kidney or liver failure, diabetes mellitus or insufficient blood clotting;
• In the absence of effectiveness from drug treatment;
• With cystostomy.

Despite the positive effect on the body, embolization of the prostate arteries is not possible in all cases.

Absolute contraindications include:

1. Occlusion of the iliac vessels;
2. Anomaly of the iliac vessels;
3. Floating blood clots.

  What is calculous prostatitis and methods of its treatment?

Preparation and performance of the operation

Embolization of prostate arteries does not require any preparation as such. Before going to the doctor, a man must completely shave his groin hair and also refuse food 4 hours before the intervention. Only drinking a small amount of clean water is allowed.

If any pathogenic microorganisms are present in the blood, the man is prescribed antibiotics. Also, before taking a man into the treatment room, he is given a small dose of sedatives and painkillers.

When the specialist checks all the indicators, a Foley catheter is inserted into the patient.

Embolization of the prostate arteries is carried out in the following way:

1. The patient is placed on the operating table. After this, sensors are connected to his chest, with the help of which it is possible to monitor the state of the body. A device for measuring blood pressure is also installed on the hand, and a sensor is installed on the finger to determine the amount of oxygen in the peripheral parts;
2. A small puncture is made at a distance of several cm from the inguinal fold;
3. After this, the specialist performs an arteriography procedure of the artery branches. They allow you to study the patency of blood vessels;
4. A small blood supply device is placed in the prostate gland;
5. The specialist installs a small microcatheter, the diameter of which does not exceed 1 centimeter, into the incision;
6. He inserts the embolization machine into this device. It releases particles of medical plastic into the blood vessels;
7. After introducing these small particles, the specialist performs a second contrast contrast test. This is necessary so that he is convinced of the correctness of the actions;
8. At the end of the procedure, the patient returns to the room.

Efficiency of the procedure

The effectiveness of prostate artery embolization has been evaluated by numerous experts from around the world. A large number of documents were compiled, thanks to which specialists from the World Health Organization managed to include embolization in the list of low-traumatic effects. Typically, this effect is prescribed for men aged 50-90 years.

Embolization also allows you to get rid of adenoma and prostatitis in people who are overweight.

Statistics show that already 1 month after the intervention, men show lasting improvements. The size of the tumor decreases significantly, and the process of urination returns to normal. In 30% of patients, significant changes appear after 1 week. In general, it takes 1 year for the full effect to appear. During this time, the swelling will completely subside and the process of urination will improve.

Studies have shown that prostate artery embolization can achieve the following results:

• The volume of the neoplasm has noticeably decreased;
• The size of the adenoma decreased by about 2 times;
• The PSA level dropped to 5.37 ng/ml if the man had a bladder catheterization;
• The PSA level dropped to 3.5 ng/ml if the man did not have catheterization;
• The rate of urination was restored to the level of 13-16 ml/s, the duration was reduced to 30 seconds.

If embolization of the prostate arteries was carried out in those men who suffered from the problem of acute urinary retention, they had to have a catheter installed to drain this fluid. However, in 30% of cases, the restoration of the natural process of urination is carried out without outside help.

Only 2% of men had serious problems that required surgery to correct the problem. In most cases, normal urine flow was restored after about 1-1.5 months.

Rehabilitation

Embolism of the prostate arteries is a fairly safe intervention, which is performed under general anesthesia. It is prescribed for the treatment of prostate adenoma or prostate hyperplasia. After placing the balls in the lumen of the blood arteries, tumor markers enter the body and are then excreted along with the urine.

Usually the operation does not require a recovery period; it is tolerated quite easily. During the rehabilitation period, a man does not need to do bandages, go to procedures or treat stitches.

If the operation proceeds normally, the man can be discharged from the hospital the very next day. To carry out full treatment: examination, surgery and recovery, only 3 days are needed. Prostate artery embolization is a fairly safe procedure that rarely causes side effects.

Unpleasant sensations in the groin, disturbances in urination and sexual function may occur. Typically, such phenomena require symptomatic therapy. In rare cases, relief from the negative consequences of the intervention occurs through surgical treatment.

Source: https://kupiviagru.info/lechenie/embolizatsiya-arterij-prostaty.html