Is there any potential role for the elastography on the evaluation of clinical success of prostate artery embolization (PAE) on the treatment of benign prostatic hyperplasia (BPH)?

Konstantinos Stamatiou

Abstract


Benign prostatic hyperplasia (BPH) is a very common condition in the male. It typically occurs in the sixth and seventh decades. Actually BPH is a histologic finding that becomes a clinical entity if and when it is associated with subjective symptoms. Not all men with histologic BPH will have significant lower urinary tract symptoms (LUTS) and other men who do not have histologic BPH will develop. In fact LUTS are also present in other diseases such as infection and cancer of the prostate, urethral stricture, etc. Traditionally, symptomatic benign prostatic hyperplasia is treated with either medical therapy or surgery. Among prostate-directed treatment modalities, prostate artery embolization (PAE) is the less invasive non pharmaceutical treatment. Initial studies showed that PAE led to reduction of the prostatic volume, symptom remission and improvements in quality of life. As a relatively new procedure, few data exist to clearly determine the exact mechanism(s) by which PAE achieve the above results.


Keywords


benign prostatic hyperplasia; lower urinary tract symptoms; symptom remission; prostatic volume; prostate artery embolization; prostate medical treatment; prostate surgery

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References


Auffenberg GB, Helfand BT, McVary KT. Established medical therapy for benign prostatic hyperplasia. Urol Clin North Am 2009;36: 443-59.

Lawson RK. Role of growth factors in benign prostatic hyperplasia. Eur Urol 1997;32(Suppl 1): 22-27.

Gat Y, Gornish M, Heiblum M, Joshua S. Reversal of benign prostate hyperplasia by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment. Andrologia 2008;40(5): 273-281.

Kim EH, Larson JA, Andriole GL. Management of Benign Prostatic Hyperplasia. Annual Review of Medicine 2016;67: 137-51

Roehrborn CG. Pathology of benign prostatic hyperplasia. Int J Impot Res 2008;20: S11-S18.

Lawrentschuk N, Perera M. Benign Prostate Disorders. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.

Wasserman, Neil F. Benign Prostatic Hyperplasia: A Review and Ultrasound Classification. Radiologic Clinics of North America 2006; 44(5): 689-710.

Stroup SP, Palazzi-Churas K, Kopp RP, Parsons JK. Trends in adverse events of benign prostatic hyperplasia (BPH) in the USA, 1998 to 2008. BJU Int 2012;109: 84-87

Lepor H, Tang R, Shapiro E. The alpha adrenoceptor subtype mediating the tension of human prostatic smooth muscle. Prostate 1993;22: 301i307

Roehrborn CG, Boyle P, Nickel JC, et al. Efficacy and safety of a dual inhibitor of 5-alpha reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002;60: 434-441.

Lieberman AJ. Managing Anticholinergic Side Effects. Prim Care Companion J Clin Psychiatry 2004; 6(suppl 2): 20-23.

McVary KT, Roehrborn CG, Kaminetsky JC, et al. Tadalafil relieves lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2007;177: 1401-1407.

McVary KT. BPH: epidemiology and comorbidities. Am J Manage Care 2006;12(5 Suppl): S122-S128

Berardinelli F, Hinh P, Wang R. Minimally invasive surgery in the management of benign prostatic hyperplasia. Minerva Urol Nefrol 2009;61(3): 269-89.

Yoshinaga EM, Galvao O, da Motta-Leal-Filho JM, et al. Magnetic ressonanse analysis of prostatic volume after prostatic artery embolization (PAE) for treatment of benign prostatic hyperplasia (BPH). J Urol 2013;189(4S/Supplement): e820

Frenk NE, Baroni RH, Carnevale FC, et al. MRI findings after prostatic artery embolization for treatment of benign hyperplasia. AJR Am J Roentgenol 2014;203(4): 813-21.

Lin YT, Amouyal G, Correas JM3,et al.Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE. Eur Radiol 2016;26(10): 3466-3473.

Kisilevzky N, Faintuch S. MRI assessment of prostatic ischaemia: best predictor of clinical success after prostatic artery embolisation for benign prostatic hyperplasia. Clin Radiol.2016;71(9): 876-882

Camara-Lopes G, Mattedi R, Antunes AA, et al. The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia. Int Braz J Urol 2013;39(2): 222-227.

Assis, AM, Rodrigues VCP, Yoshinaga EM, et al. Prostatic artery embolization (PAE) for treatment of benign prostatic hyperplasia in patients with prostates exceeding 90g: a prospective single center study. J Vasc Interv Radiol 2015;26 (1): 87-93.

Bagla S, Smirniotopoulos JB, Orlando JC, et al. Comparative Analysis of Prostate Volume as a Predictor of Outcome in Prostate Artery Embolization. Vasc Interv Radiol 2015;26(12): 1832-1838.

Pereira K, Halpern JA, McClure TD, et al. Role of prostate artery embolization in the management of refractory haematuria of prostatic origin. BJU Int 2016;118(3): 359-365.

Little MW, Boardman P, Macdonald AC, et al. Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case-Control Study. Cardiovasc Intervent Radiol 2017; 40(5): 682-689.

Sun F, Crisóstomo V, Báez-Díaz C, Sánchez FM. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale. Cardiovasc Intervent Radiol 2016;39(2): 161-169.

Camara-Lopes G, Mattedi R, Antunes AA .The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia. Int Braz J Urol 2013; 39(2): 222-7.

Frangogiannis NG, Michael LH, Entman ML. Myofibroblasts in reperfused myocardial infarcts express the embryonic form of smooth muscle myosin heavy chain (SMemb). Cardiovasc Res 2000; 48: 89-100.

Willems IE, Havenith MG, De Mey JG, Daemen MJ. The alpha-smooth muscle actin-positive cells in healing human myocardial scars. Am J Pathol 1994;145: 868-875.

Kim W, Ferguson VL. Application of Elastography for the Noninvasive Assessment of Biomechanics in Engineered Biomaterials and Tissues. Ann Biomed Eng 2016;44(3): 705-724.




DOI: http://dx.doi.org/10.19264/hj.v29i3.198