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PROSTATE TREATMENT IN LYON

embolisation-prostate.webp

What is theprostate embolization?

L'embolizationby the prostatic arteries (PAE) is aalternativeminimally invasivenon surgical  guided by imagery ofinterventional radiology in Lyonfor the treatment of adenoma or hypertrophy ofprostate for patients who do not wish or cannot be operated on, when there is an obstruction of the urinary stream with a significant impact on your quality of life.

Prostate embolizationis a technique that is no longer so recent, having emerged 15 years ago in Portugal, and has since been practiced on thousands of patients in most Western countries (1).

It consists in introducing a small catheter under local anesthesia in the leg or the wrist, then to slip to the prostatic arteries in order to deposit thousands of small balls there (embolization). The prostate will thus soften and decrease in size and thus leaves more room for the urinary stream.

Hisefficiencyto treat obstructive symptoms ofprostate adenomashas been demonstrated with the highest level of scientific evidence (Level 1) in 2020 (2).

PROSTATE EMBOLIZATION PROCEDURE EN IMAGE

Adénome en IRM

Adénome en IRM

Volumineux adénome de prostate visible sous la vessie en IRM

Scanner des artères

Scanner des artères

Un scanner du pelvis est réalisé avec une injection de produit de contraste afin d'anticiper la route à prendre pour accéder aux artères prostatiques

Fusion du scanner en salle

Fusion du scanner en salle

Le jour du traitement votre scanner est fusionné directement en salle sur votre corps

Artère de la prostate

Artère de la prostate

Cela permet de repérer bien plus facilement la petite artère de prostate à cathéteriser

Embolisation gauche

Embolisation gauche

Une fois dans l'artère au contact de la prostate on vérifie l'absence d'anastomose avec d'autre organe, et l'embolisation peut commencer ! La même embolisation est réalisée des 2 cotés

Repérage 3D

Repérage 3D

En cas de doute sur les artères, les salles de radiologie interventionnelle avancées permettent de réaliser en direct des mini scanner et élimine ainsi toute embolisation hors cible.

Compression au poignet

Compression au poignet

En fin de procédure un pansement comprime quelques minutes votre poignet ou votre jambe au point d'entrée dans l'artère.

How is prostatic artery embolization performed?

How effective and eare there any side effects?

You aretreated in Lyon on an outpatient basisor on a night of hospitalization. More than half of the patients have a post embolization syndrome for 3 to 7 days with bladder irritation and frequent urination.

In one of the largest series of 630 patients with 5 years of follow-up (3), the symptoms are significantly improved in 85% of cases at 1 and 3 months, again 75% at 5 years. Complications are exceptional thanks to our new radiology rooms but mustbe known (in thesame  series 2 out of 630 patients) and are related to the embolization of an arteryirrigating an organ other than the prostate.  Unlike surgery, there is never retrograde ejaculation, nor a decline in sexual function (which would besame increased according to some studies). Of course, like any treatment, there can always be exceptional cases.

The main defect of this technique is in fact its technical difficulty, the arteries beingvery petites (especially since the prostate is small), catheterization canbe  complex and long (1h30 average procedure). There is 5% technical failure. She mustbe  performed by an interventional radiologist expert in the manipulation of microphonescatheters, and trained in fine pelvic anatomy to identify any anastomoses to avoid.

The interventional radiologist sees you again onLyonsor in Visio Consultation at 1 month to judgethe absence  of complications and functional improvement, then at 3 months with a prostate MRI to judge the reduction in the volume ofadenoma.

A failure orsame  an embolization that does not sufficiently improve the patient does not in any way prevent surgeryafter.

After several years, the adenoma may enlarge and thesymptoms  urinary obstructions come back, requiring new treatment. Embolization of the adenoma ofprostateshould not change the follow-up you have with your urologist or GPre  the general risk of cancer of theprostate, which is a whole different disease. 

What are the indications for prostate embolization?

You are a good candidate for embolization of theprostateif:

- You have obstructive urinary symptoms related to your adenoma judged moderate to severe (ipss score) and affecting your quality of life, or you have already had a complication related to your adenoma (infection, urinary retention with indwelling catheter) .

- AND You do not wish to be operated on, in particular to preserve your ejaculation, or you cannot be operated on for anesthetic risks or bleeding (anticoagulant).

Embolyon

Le Dr Charles Mastier est fondateur d'Embolyon votre premier centre dédié à l'embolisation. Apprenez en plus sur l'embolisation de la prostate ci-dessous! 

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