[Selective arterial embolization in the treatment of intractable hematuria].
OBJECTIVE
Non tractable hematuria has a varied etiology. It may be a complication difficult to treat. We report the case treated in our hospital by selective arterial embolization.


METHODS
We report the case of an 86-year-old patient who underwent radiotherapy for transitional cell carcinoma. Later on, she presented with hematuria, not responding to usual therapeutic management. Urinary diversion did not solve the problem either. We decided to proceed with selective arterial embolization of the hypogastric arteries using polyvinylalcohol microspheres and metallic coils.


RESULTS
Hematuria disappeared after embolization, without the recurrence after nine months of follow-up. Immediate outcome was characterized by a post-embolization syndrome which was treated with antipyretics, antibiotic and morphine derivatives. It diminished progressively and disappeared in 48 hours.


CONCLUSIONS
Arterial selective embolization is a useful therapeutic resource for the management of non tractable hematuria, mainly in cancer patients, which present a deteriorated general status.
Argüelles Salido
Enrique
E
Servicio de Urologia, Unidad de Uro-Oncología, Hospitales Universitarios Virgen del Rocío, Sevilla, España. earguelles@telefonica.net
Medina López
Rafael Antonio
RA
Iglesias López
Alvaro
A
Congregado Ruiz
Carmen Belén
CB
Peiró de las Heras
Javier
J
Pascual del Pobil Moreno
José Luis
JL
D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D006417:Hematuria / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007269:Injections, Intra-Arterial; D008863:Microspheres; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D009392:Nephrectomy; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D014513:Ureter / Q000601:surgery; D014519:Ureterostomy; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy / Q000601:surgery; D014547:Urinary Diversion