Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases.
OBJECTIVE
We report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH).


METHODS
All patients were embolized with 100- to 300-μm microspheres alone or in combination with 300- to 500-μm microspheres.


RESULTS
During follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients.


CONCLUSIONS
Urethral obstruction after PAE caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.
Department of Radiology, University of Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil.
Leandro Cardarelli
LC
Leite
Department of Radiology, University of Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil.
Andre Moreira
AM
de Assis
Department of Radiology, University of Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil.
Airton Mota
AM
Moreira
The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
Sardis Honoria
SH
Harward
Discipline of Urology, University of Sao Paulo, Sao Paulo, SP, Brazil.
Alberto Azoubel
AA
Antunes
Department of Radiology, University of Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil. francisco.carnevale@criep.com.br.
Francisco Cesar
FC
Carnevale
D000368:Aged; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply* / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome; D014554:Urination; D014563:Urodynamics
Benign prostatic hyperplasia; International prostate symptom score; Lower urinary tract symptoms; Prostatic artery embolization