Francesco Carnevale, São Paulo, Brazil, told delegates about the specifics of the case in New York. The embolization was performed in Brazil by Joaquim Mauricio da Motta-Leal-Filo, Airton Mota Moreira and Octavio Galvao.
“The patient is a 60-year-old with no comorbidities who had taken medication for BPH for the past five years. He has refractory lower urinary tract symptoms but no urinary infection or acute urinary retention. The main lower urinary tract symptoms include urinary hesitancy, weak urinary stream, urinary urgency and nocturia (3x). The patient has a severe International Prostate Symptom Score (IPSS) of 26 and a low quality of life score of five,” he said.
He also noted that a digital rectal exam had revealed a 70g prostate with no nodules; urodynamic testing had shown an infravesical obstruction and that the Qmax was 6.5mL/second.
In this case, the a 5F sheath pigtail and vertebral catheter (from Merit Medical), a microcatheter, the Renegade STC angled (from Boston Scientific) , a microwire, Fathom 0.016”, (from Boston Scientific) and 300-500μm Embospheres (from Merit Medical) were the materials used for embolization. The endpoint was slow flow, or near stasis in the prostatic vessels, Carnevale noted.
GEST 2012 US delegates heard experts debate the best candidates for prostatic artery embolization for BPH, the best technique, the most useful imaging modality, and best embolic agents to be used for this novel procedure. They also heard about medical and surgical therapies and their limitations, the pre-embolization work-up, prostatic arterial anatomy, and results of the procedure. The importance of working in a multidisciplinary team with good co-operation with urologists was also highlighted.