title: Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it.
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.
authors.affiliation: Interventional Radiology Unit, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-001, Brazil. fcarnevale@uol.com.br.|, Rua Teodoro Sampaio, 352/17, 05406-000, São Paulo, Brazil. fcarnevale@uol.com.br.
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Carnevale
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-001, Brazil.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods; D054893:Cone-Beam Computed Tomography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000517:prevention & control; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009929:Organ Size; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011467:Prostate / Q000098:blood supply*; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000628:therapy*; D011788:Quality of Life; D015641:Radiography, Interventional / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods