Zhang Jin Long, Yuan Kai, Wang Mao Qiang, Yan Jie Yu, Wang Yan, Zhang Guo Dong
School of Medicine, Nan Kai University, 94 Wei-jin Rd, Tianjin, 300071, People's Republic of China.
Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing, 100853, People's Republic of China.
BMC Urol. 2018 Oct 24;18(1):92. doi: 10.1186/s12894-018-0407-7.
Prostatic artery embolization (PAE) has been proved effective in the treatment of lower urinary tracts (LUTS) secondary to benign prostatic hyperplasia (BPH) with low complications, and most of the them are due to non-target embolization of adjacent organs, such as bladder, rectum, seminal vesicles and penis. Aim of this study was to present seminal vesicle (SV) abnormalities following prostatic artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia.
We reviewed 139 BPH patients who received PAE during the period of February 2009 and January 2015 at a single institution, highlighting seminal vesicle abnormalities and their clinical relevance after PAE. PAE was performed using 90~ 180-μm (mean 100-μm) polyvinyl alcohol foam particles.
Nine of 139 patients with SV abnormalities (6.5%) were identified by magnetic resonance imaging (MRI), including subacute haemorrhage in 3 patients and ischaemia in 6 patients. Using cone-beam computed tomography (CB-CT), the seminal vesicle arteries were identified 8 of the 9 patients. All 9 patients complained of a few episodes of mild haematospermia during the 1-4 weeks after PAE; the haematospermia disappeared spontaneously without any treatment.
SV haemorrhage and ischaemia may occur after PAE, and these patients may present with transient and self-limited haematospermia.
前列腺动脉栓塞术(PAE)已被证明在治疗继发于良性前列腺增生(BPH)的下尿路症状(LUTS)方面有效,且并发症发生率低,其中大多数并发症是由于对邻近器官(如膀胱、直肠、精囊和阴茎)的非靶向栓塞所致。本研究的目的是介绍前列腺动脉栓塞术(PAE)治疗有症状的良性前列腺增生后精囊(SV)的异常情况。
我们回顾了2009年2月至2015年1月期间在单一机构接受PAE治疗的139例BPH患者,重点关注PAE后精囊异常及其临床相关性。PAE使用90~180μm(平均100μm)的聚乙烯醇泡沫颗粒进行。
139例患者中有9例(6.5%)经磁共振成像(MRI)发现精囊异常,其中3例为亚急性出血,6例为缺血。使用锥形束计算机断层扫描(CB-CT),9例患者中有8例发现了精囊动脉。所有9例患者在PAE后1~4周内均出现几次轻度血精;血精未经任何治疗自行消失。
PAE后可能发生精囊出血和缺血,这些患者可能出现短暂的、自限性的血精。