Clinical study of prostatic arterial embolization jointly with Bletilla Striata for the treatment of benign prostatic hyperplasia

doi:10.3877/cma.j.issn.2095-5782.2017.02.008

Abstract

Abstract:

Objective:

To explore the efficacy of Bletilla Striata combined with prostatic artery embolization (PAE) in the treatment of benign prostatic hyperplasia (BPH) and determine its feasibility and safety.

Methods:

PAE with Bletilla Striata were performed in thirty patients with BPH who failed in medical treatment. International Prostate Symptom Score (IPSS), Quality of Life (QOL) and International Index of Erectile Function (IIEF) were recorded. Peak urinary flow (Qmax), postvoid residual volume (PRV) and prostate volume (PV) were also measured before and after PAE. The complications were retrospectively analyzed.

Results:

PAE was technically successful in twenty-nine patients. Follow-up time was 12 months. IPSS was decreased from 26.69 to 6.14 points, QOL was improved from 4.76 to 1.22 points (P<0.05), and IIEF decreased 0.21 points (from 13.90 to 13.69), but there was no significant difference (P>0.05). Qmax increased 13.03 ml/s (from 9.75 to 22.79 ml), while PVR decreased from 131.79 ml to 4.45 ml (P<0.05). A mean prostate volume was reduced by 62.19% (85.66 to 32.38 ml) (P<0.05). There were three minor complications, one with mild hematuresis and two with pain in perineum regions. One patient had skin necrosis in the perineum region.

Conclusions:

PAE in treatment of BPH with Bletilla Striata is feasible, efficacious and safe. However, further studies are needed to assess its longer term result and potential morbidity.

Key words: Benign prostatic hyperplasia, Prostatic artery embolization, Bletilla Striata, Interventional radiology

Xuelu Zhou, Shangjun Zhou, Ping Zhan, Gang Ye, Jifeng Zhang, Jianfeng Zhang, Hao Hu. Clinical study of prostatic arterial embolization jointly with Bletilla Striata for the treatment of benign prostatic hyperplasia[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(02): 89-93.

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References 17

1	叶淦，周学鲁. 动脉栓塞治疗良性前列腺增生的研究进展[J]. 中华介入放射学电子杂志, 2017, 5(1):36-40. doi: 10.3877/cma.j.issn.2095-5782.2017.01.011.
2	郑传胜，冯敢生，周汝明, 等. 中药白芨的新用途——栓塞肝动脉治疗肝癌[J]. 中华肿瘤杂志, 1996, 18(4):305-307.
3	莫琰，周学鲁，张继峰, 等. 白芨前列腺动脉栓塞治疗良性前列腺增生的初步研究[J]. 广东医学, 2013, 34(增刊l):260-262.
4	张祥华. 良性前列腺增生诊断治疗指南. 见：那彥群, 主编. 中国泌尿外科疾病诊断治疗指南. 第1版. 北京:人民卫生出版社, 2011：116-131.
5	Sun F, Sánchez FM, Crisóstomo V, et al. Transarterial prostatic embolizaion: initial experience in a canine modal [J]. AJR, 2011, 197(2):495-501. doi: 10.2214/AJR.10.5947.
6	谢庆祥，裴发光，孟家榕. 前列腺增生组织中血管形成的研究[J]. 中华泌尿外科杂志, 1999, 20(4): 246-248.
7	Sun F, Sánchez, FM, Crisóstomo V, et al. Transcatheter arterial embolization as potential treatment—preliminary study in Pigs [J]. Radiology, 2008, 246(3):783-789. doi:10.1148/radiol.2463070647.
8	DeMeritt JS, Elmasri FF, Esposito MP, et al. Relief of benign prostatic hyperplasia related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization[J] . J Vasc Interv Radiol, 2000, 11(6):767-770.
9	林举择，常钢.中药莪术油及鸦胆子油经血管介入治疗良性前列腺增生症的临床观察[C]. 广州，广州中医药大学，2006.
10	肖绍树，贺降福，刘荣. 脾部分栓塞治疗肝硬化并脾功能亢进的并发症及处理 [J]．临床消化病杂志，1999，11(4): 170-171．
11	梁丽. 子宫动脉栓塞治疗子宫肌瘤的临床疗效观察[J]. 中国医学工程, 2010, 18(1):161-162.
12	陈晓春，冯敢生，张润清, 等. 白芨选择性肾动脉栓塞治疗肾错构瘤疗效观察[J]. 临床泌尿外科杂志, 2000, 15(6):253-254.
13	杨建勇，冯敢生. 中药白芨作为栓塞剂运用于骨骼肿瘤的治疗[J]. 放射学实践, 1996,11(2):63-66.
14	Wang M, Guo L, Duan F, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates [J]. BJU Int, 2016,117(1):155-164. doi:10.1111/bju.13147.
15	Wang MQ, Wang Y, Yan JY, et al. Prostatic artery embolization for the treatment of symptomatic benign prostatic hyperplasia in men ≥75 years: a prospective single-center study [J]. World J Urol, 2016, 34(9):1275-1283. doi:10.1007/s00345-016-1771-0.
16	张嘉诚，卢伟. 前列腺栓塞术治疗良性前列腺增生的临床应用进展 [J]. 转化医学杂志, 2015, 4(3):182-189. doi:10.3969/j.issn.2095-3097.2015.03.015.
17	黄恒海，薛元领，黄志红, 等. 髂内动脉-前列腺动脉化疗栓塞治疗晚期前列腺癌 [J]. 中国临床新医学, 2009, 12(2):1257-1259. doi:10.3969/j.issn.1674-3806.2009.12.11.

临床指标	栓塞前(n=30)	术后（n=29）				F值	P值
临床指标	栓塞前(n=30)	1个月	3个月	6个月	12个月	F值	P值
IPSS(分)	26.69±3.63	20.14±3.37	15.28±3.85	11.83±1.87	6.14±1.53	115.42	<0.01
QOL(分)	4.76±0.64	3.76±0.58	2.81±0.49	2.35±0.39	1.22±0.45	96.16	<0.01
Qmax(mL/s)	9.75±2.03	14.24±1.98	17.03±2.31	20.93±2.25	22.79±2.38	112.21	<0.01
PRV(ml)	131.79±19.16	44.07±7.70	30.69±4.13	13.89±2.97	4.45±2.50	112.53	<0.01
IIEF(分)	13.90±2.72	13.89±2.73	13.93±2.73	14.00±2.77	13.69±2.07	8.90	0.064
PV(ml)	85.66±24.11	73.62±12.94	54.28±9.14	43.14±7.80	32.38±3.34	106.37	<0.01

临床指标	栓塞前(n=30)	术后（n=29）				F值	P值
临床指标	栓塞前(n=30)	1个月	3个月	6个月	12个月	F值	P值
IPSS(分)	26.69±3.63	20.14±3.37	15.28±3.85	11.83±1.87	6.14±1.53	115.42	<0.01
QOL(分)	4.76±0.64	3.76±0.58	2.81±0.49	2.35±0.39	1.22±0.45	96.16	<0.01
Qmax(mL/s)	9.75±2.03	14.24±1.98	17.03±2.31	20.93±2.25	22.79±2.38	112.21	<0.01
PRV(ml)	131.79±19.16	44.07±7.70	30.69±4.13	13.89±2.97	4.45±2.50	112.53	<0.01
IIEF(分)	13.90±2.72	13.89±2.73	13.93±2.73	14.00±2.77	13.69±2.07	8.90	0.064
PV(ml)	85.66±24.11	73.62±12.94	54.28±9.14	43.14±7.80	32.38±3.34	106.37	<0.01

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