title: Role of prostate artery embolization in the management of refractory haematuria of prostatic origin.
abstract: Prostatic haematuria is among the most common genitourinary complaints of emergency room visits, distressing and troublesome to men and a challenging clinical problem to the treating physician. The most common aetiologies of prostatic haematuria include benign prostatic hyperplasia and prostate cancer. Prostatic haematuria usually resolves with conservative and medical methods; failure of these interventions results in refractory haematuria of prostatic origin (RHPO), a potentially life-threatening scenario. Several different treatments have been described, with varying degrees of success. Patients with RHPO are often elderly and unfit for radical surgery. Prostate artery embolization (PAE) has evolved as a safe and effective technique in the management of RHPO. Use of a superselective approach optimizes clinical success while minimizing complications. This minimally invasive approach improves patients with haemodynamic instability, serves as a bridge to elective surgery, and is a highly effective treatment for RHPO. It may obviate the need for more invasive and morbid surgical therapies. The aim of the present review was to describe the current management of RHPO and the technique of PAE and to review its efficacy and associated morbidity.
authors.affiliation: Department of Interventional Radiology, St. Louis University Hospital, St. Louis, MO, USA.
authors.forename: Keith
authors.identifier: 0000-0002-0155-908X
authors.initials: K
authors.lastname: Pereira
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Halpern
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: McClure
authors.affiliation: Department of Radiology, Wayne State University, Detroit, MI, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Lewis
authors.affiliation: Department of Interventional Radiology, Jackson Memorial Hospital/University of Miami Hospital, Miami, FL, USA.
authors.forename: Isaam
authors.initials: I
authors.lastname: Kably
authors.affiliation: Department of Interventional Radiology, Jackson Memorial Hospital/University of Miami Hospital, Miami, FL, USA.
authors.forename: Shivank
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jim C
authors.initials: JC
authors.lastname: Hu
mesh_terms: D001158:Arteries; D004621:Embolization, Therapeutic; D006417:Hematuria / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D011467:Prostate / Q000098:blood supply*; D011470:Prostatic Hyperplasia / Q000150:complications*; D011471:Prostatic Neoplasms / Q000150:complications*
keywords: benign prostatic hyperplasia; prostate artery embolization; prostate cancer; refractory haematuria