Prostate artery embolization for the treatment of urinary retention caused by large(>80 mL) benign prostatic hyperplasia: Results of 21 patients

Objective:A large prostate size(>80 m L)of benign prostatic hyperplasia(BPH)is technically challenging to treat surgically.This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization(PAE)for the treatment of urinary retention caused by large BPH.Methods:A total of 21 patients with urinary retention,indwelling urinary catheter,or suprapubic cystostomy as a consequence of giant BPH(prostate volume[PV]>80 mL)who sought treatment between January 2013 and December 2017 were enrolled.A microcatheter(1.9–2.7 Fr)and a"two-step embolization"combining 50-μm and100-μm polyvinyl alcohol embolization particles were used in all patients.International Prostate Symptom Score(IPSS),quality of life(QoL),PV,and prostate-specific antigen(PSA)were evaluated at 3,6,and 12 months postPAE.Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously.Results:The clinical success rate was 95.2%(20/21).Compared with pre-procedural values,IPSS,QoL,PV,and PSA showed statistically significant differences at 3,6,and 12 months post-PAE(P<0.05).There were no serious complications after PAE.Conclusions:PAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.

新西兰白兔胃左及胃十二指肠动脉栓塞减肥术后组织病理及免疫组织化学变化

目的探究新西兰白兔肥胖模型经导管胃左动脉及胃十二指肠动脉栓塞术后胃及十二指肠组织病理及免疫组织化学变化。方法成功建立新西兰白兔肥胖模型20只, 分层随机分成2组, 实验组经导管明胶海绵颗粒(350~560 μm)栓塞新西兰兔胃左动脉及胃十二指肠动脉, 对照组经导管生理盐水(5 ml)灌注胃左动脉及胃十二指肠动脉, 术后4周处死动物行胃及十二指肠组织病理、免疫组织化学检查及Western Blot检测, 测量产胃饥饿素细胞密度及胃饥饿素蛋白条带灰度比值, 采用独立样本t检验进行分析比较。结果大体病理检查提示1只实验组新西兰白兔胃体部前壁出现溃疡, 组织病理学检查提示3只实验组新西兰白兔胃体部黏膜溃疡, 免疫组织化学检查提示实验组胃基底部及十二指肠产胃饥饿素细胞较对照组显著减少(胃基底部分别为10.0±5.1、27.7±3.4, t=12.35, P<0.05;十二指肠分别为5.6±2.6、12.3±2.1, t=4.73, P<0.05)。Western Blot检测提示实验组胃基底部及十二指肠胃饥饿素蛋白条带灰度比值较对照组显著降低(胃基底部分别为0.65±0.05、1.12±0.09, t=9.62, P<0.05;十二指肠分别为0.55±0.03、0.94±0.08, t=7.98, P<0.05)。结论胃左及十二指肠动脉栓塞减肥术后免疫组织化学及Western Blot检测证实实验组白兔胃基底部及十二指肠的产胃饥饿素细胞较对照组明显减少, 且术后组织病理学检查提示此技术较为安全。