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    Evaluation of Prostatic Artery Embolization Efficiency in Benign Prostatic Hyperplasia Patients with High Comorbidity
    (Galenos Yayincilik, 2018) Yildirim, Ismail Okan; Duman, Enes; Firat, Ali; Celik, Huseyin; Sarac, Kaya
    Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.
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    Evaluation of prostatic artery embolization efficiency in benign prostatic hyperplasia patients withhigh comorbidity
    (Galenos yayıncılık, erkan mor, molla guranı cad 21-1, fındıkzade, ıstanbul 34093, turkey, 2018) Yildirim, Ismail Okan; Duman, Enes; Firat, Ali; Celik, Huseyin; Sarac, Kaya
    Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.
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    A Novel Technique in the Treatment of Lymphoceles After Renal Transplantation: C-Arm Cone Beam CT-Guided Percutaneous Embolization of Lymphatic Leakage After Lymphangiography
    (Lippincott Williams & Wilkins, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, Idris
    Background We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.
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    A novel technique in the treatment of lymphoceles after renal transplantation: c-arm cone beamct-guided percutaneous embolization of lymphatic leakage after lymphangiography
    (Lıppıncott wıllıams & wılkıns, two commerce sq, 2001 market st, phıladelphıa, pa 19103 usa, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, Idris; Sarac, Kaya
    Background We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.