Superselective embolization of bladder arteries in the treatment of intractable bladder haemorrhage.
Bladder hemorrhage following radiation therapy is a serious complication in patients undergoing this treatment. Several methods have been proposed to control this particular situation; however, results have been far from satisfactory, with the exception of drastic measures such as hypogastric artery ligation and radical cystectomy. We recently used a method of superselective embolization of the bladder arteries which enabled us to control severe intractable bleeding in a patient submitted to bladder irradiation for a transitional cell infiltrating carcinoma. Compared to selective embolization and other methods, the advantages of superselective embolization are a lower recurrence rate concerning bleeding, fewer side-effects and the possibility of using adaptable embospheres (150-1000 micron) which, on account of their marked plasticity, offer better occlusion of the vessels. For these reasons, superselective embolization of the bladder arteries should be considered as the treatment of choice in intractable bladder hemorrhage.
De Berardinis
Ettore
E
Department of Urology U Bracci, University La Sapienza, V.Policlinico, Rome, Italy.
Vicini
Patrizio
P
Salvatori
Filippo
F
Sciarra
Alessandoro
A
Gentile
Vincenzo
V
Di Silverio
Franco
F
D000368:Aged; D000792:Angiography; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000532:radiotherapy; D003558:Cystoscopy; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006417:Hematuria / Q000628:therapy; D006470:Hemorrhage / Q000628:therapy*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D011832:Radiation Injuries / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000098:blood supply / Q000528:radiation effects*; D001745:Urinary Bladder Diseases / Q000628:therapy*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000532:radiotherapy
D006490:Hemostatics