The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia

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art_CAMARA-LOPES_The_histology_of_prostate_tissue_following_prostatic_artery_2013.PDF (210.25 KB)
Citações na Scopus
37
Tipo de produção
article
Data de publicação
2013
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BRAZILIAN SOC UROL
Autores
Citação
INTERNATIONAL BRAZ J UROL, v.39, n.2, p.222-227, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: Prostatic artery embolization (PAE) for the treatment of patients with symptomatic benign prostatic hyperplasia (BPH) is believed to be a safe procedure with a low risk of adverse side effects. Artery embolization is a viable treatment option in patients who are refractory to the classic noninvasive treatments. Knowledge of the histological characteristics of prostate tissue following the procedure is still limited. In this study, we describe the microscopic aspects of the prostate following PAE for BPH. Materials and Methods: Two patients underwent transurethral resections of the prostate (TURP) after PAE. Embolizations were performed under local anesthesia with an initial pelvic angiography to evaluate the iliac vessels and the prostate arteries using a 2.8 French microcatheter. The prostate was embolized with 300-500 mu m Microspheres (Embosphere (R)), using complete blood stasis as the end point. The prostate tissues were analyzed histologically to characterize the effects of the embolization. Results: The embolic material within the prostate tissue was easily identified as homogeneous, bright eosin-red spheroids filling the vessel lumens. Ischemic necrosis surrounded or not by chronic inflammatory reactions containing macrophages were considered as a result of the artery embolization. Also, some aspects related to the healing process were observed being fibrotic nodules surrounded by glands with squamous metaplasia of the epithelial lining the most important. In the remaining sections, due to the precocious surgical intervention, the classic findings of BPH were still present with the glandular and stromal hyperplasia associated with nonspecific chronic prostatitis. Conclusions: This is the first description of prostate histology in BPH patients treated by PAE, a new procedure that is being used increasingly as a therapeutic intervention. The recognition of the changes caused by this new modality of treatment has become a very important differential in a chronic granulomatous reaction of the prostate tissue.
Palavras-chave
Prostatic Hyperplasia, Therapeutics, Arteries, Histology, Embolization, Therapeutic, Prostate
URI
https://observatorio.fm.usp.br/handle/OPI/4018
Referências
  1. APPLETON DS, 1988, BRIT J UROL, V61, P45, DOI 10.1111/j.1464-410X.1988.tb09160.x
  2. AUA Practice Guidelines Committee, 2003, J UROLOGY, V170, P530
  3. Aungst M, 2004, OBSTET GYNECOL, V104, P1161, DOI 10.1097/01.AOG.0000128107.58898.e1
  4. Barbieri A, 2002, UROL INT, V69, P318, DOI 10.1159/000066115
  5. Barry MJ, 2005, TXB BENIGN PROSTATIC, P141
  6. Carnevale FC, 2011, CARDIOVASC INTER RAD, V34, P1330, DOI 10.1007/s00270-011-0136-8
  7. Carnevale FC, 2010, CARDIOVASC INTER RAD, V33, P355, DOI 10.1007/s00270-009-9727-z
  8. Cioanta I, 2000, Tech Urol, V6, P294
  9. Emberton M, 2003, UROLOGY, V61, P267, DOI 10.1016/S0090-4295(02)02371-3
  10. Evans AJ, 2011, ADV ANAT PATHOL, V18, P281, DOI 10.1097/PAP.0b013e318220f5b1
  11. GUESS HA, 1990, PROSTATE, V17, P241, DOI 10.1002/pros.2990170308
  12. HUMPHREY PA, 1993, AM J CLIN PATHOL, V99, P746
  13. Issa MM, 2006, AM J MANAG CARE, V12, pS83
  14. Kuzel D, 2011, FERTIL STERIL, V95, P2143, DOI 10.1016/j.fertnstert.2010.12.014
  15. Merrimen JL, 2009, J UROLOGY, V182, P485, DOI 10.1016/j.juro.2009.04.016
  16. Michel F, 2002, J UROLOGY, V168, P2550, DOI 10.1097/01.ju.0000036371.49460.7d
  17. MITCHELL ME, 1976, J UROLOGY, V115, P692
  18. Rastinehad AR, 2008, UROLOGY, V71, P181, DOI 10.1016/j.urology.2007.09.012
  19. Roehrborn CG, 1998, UROLOGY, V51, P19, DOI 10.1016/S0090-4295(97)00571-2
  20. Roehrborn CG, 1998, UROLOGY, V51, P415, DOI 10.1016/S0090-4295(97)00682-1
  21. Sun F, 2008, RADIOLOGY, V246, P783, DOI 10.1148/radiol.2463070647
  22. Takeda A, 2008, J MINIM INVAS GYN, V15, P212, DOI 10.1016/j.jmig.2007.09.006
  23. Wheelahan J, 2000, BJU INT, V86, P805, DOI 10.1046/j.1464-410x.2000.00920.x
  24. Ziada A, 1999, UROLOGY, V53, P1, DOI 10.1016/S0090-4295(98)00532-9

Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
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