Objective: In this article, we aimed to share our experience with superselective vesical and prostatic artery embolization applied by transar-terial microcatheter method as a treatment option for recurrent resistant hematuria due to bladder and prostate cancer in elderly and comorbid pa-tients.
Materials and Methods: Bilateral transarteri-al microcatheter method was used for superselec-tive vesical or prostatic artery embolization in 10 patients whose follow-up treatment was continued in our clinic with macroscopic hematuria due to bladder and prostate cancer diagnoses and could not be treated with other palliative and radical sur-gical methods due to comorbidity and high sur-gical operative risk. Before and after embolization treatment; hemoglobin (Hb) and hematocrit (Hct) values of the patients, the amount of transfusion of blood and blood products, postoperative compli-cations, urethral foley catheter removal times and patient satisfaction were evaluated. The patients were followed up with controls intermittently for an average of 15 months.
Results: The mean age of the patients includ-ed in the study was 77.5 (69-86) years. The average hemoglobin value before and after the emboliza-tion procedure was 8,16 mg/dL and 9,48 mg/dL, respectively. The average hematocrit value before and after the embolization procedure was 25,5 and 30,4 , respectively. The average amount of blood products (erythrocyte suspension) transfusion was 2.1 (1-3) units before the procedure, and there was no need for blood trans-fusion in the follow-up after the procedure. The urethral catheters of all patients were removed on the 5th day (3-7 days) after the urine color became completely clear. There were no major complications, recurrent urethral catheterization or mortality, morbidity related to the treatment after the embolization procedure.
Conclusion: Superselective vesical and prostatic artery embo-lization treatment applied by transarterial microcatheter method is an effective and reliable alternative in the case of resistant hematu-ria due to bladder or prostate cancer that cannot be controlled with other palliative methods due to the high risk of anesthesia in elderly patients with comorbidities.
Keywords: persistent hematuria, bladder cancer, superselective vesical artery embolization
ABSTRACT
Objective: In this article, we aimed to share our experience with superselective vesical and prostatic artery embolization applied by transar-terial microcatheter method as a treatment option for recurrent resistant hematuria due to bladder and prostate cancer in elderly and comorbid pa-tients.
Materials and Methods: Bilateral transarteri-al microcatheter method was used for superselec-tive vesical or prostatic artery embolization in 10 patients whose follow-up treatment was continued in our clinic with macroscopic hematuria due to bladder and prostate cancer diagnoses and could not be treated with other palliative and radical sur-gical methods due to comorbidity and high sur-gical operative risk. Before and after embolization treatment; hemoglobin (Hb) and hematocrit (Hct) values of the patients, the amount of transfusion of blood and blood products, postoperative compli-cations, urethral foley catheter removal times and patient satisfaction were evaluated. The patients were followed up with controls intermittently for an average of 15 months.
Results: The mean age of the patients includ-ed in the study was 77.5 (69-86) years. The average hemoglobin value before and after the emboliza-tion procedure was 8,16 mg/dL and 9,48 mg/dL, respectively. The average hematocrit value before and after the embolization procedure was 25,5 and 30,4 , respectively. The average amount of blood products (erythrocyte suspension) transfusion was 2.1 (1-3) units before the procedure, and there was no need for blood trans-fusion in the follow-up after the procedure. The urethral catheters of all patients were removed on the 5th day (3-7 days) after the urine color became completely clear. There were no major complications, recurrent urethral catheterization or mortality, morbidity related to the treatment after the embolization procedure.
Conclusion: Superselective vesical and prostatic artery embo-lization treatment applied by transarterial microcatheter method is an effective and reliable alternative in the case of resistant hematu-ria due to bladder or prostate cancer that cannot be controlled with other palliative methods due to the high risk of anesthesia in elderly patients with comorbidities.
Keywords: persistent hematuria, bladder cancer, superselective vesical artery embolization