Objectives: To compare post-operative bleeding measures in patients who underwent prostatic artery embolization (PAE) prior to water-jet ablation (aquablation) vs. water-jet ablation alone. Methods: A retrospective review identified 145 patients treated with water-jet ablation for benign prostatic hyperplasia from December 2018 to June 2021. Patients were divided into two groups: water-jet ablation alone (n = 56) vs. pre-operative PAE and water-jet ablation (n = 89). Patient demographics, pertinent laboratory values, operative reports, and hospital courses were reviewed. Results: PAE was technically successful in all patients (n = 89), and all 89 patients underwent successful water-jet ablation within a median time of 2 days. Compared to water-jet ablation alone, pre-operative PAE resulted in a significant reduction in post-operative bleeding as measured via lower rates of continuous bladder irrigation, hemostatic measures, and hematuria. Pre-operative PAE was also associated with lower rates of post-operative urinary retention (odds ratio 17, p = 0.02) and less likely to require reoperation 30 days after the procedure (p = 0.003). There were no major PAE-related adverse events reported in the combination arm. Conclusions: Compared to water-jet ablation alone, pre-operative PAE resulted in fewer bleeding-related complications and urinary retention.
Journal of clinical medicine. 2024 Nov 18*** epublish ***
Sandeep Bagla, Inderjit Singh, Abin Sajan, Antony Sare, Alex Pavidapha, Tej Mehta, John Klein, Shawn Marhamati, Lori Lerner
IR Centers USA, 2755 Hartland Road, Falls Church, VA 22043, USA., Potomac Urology, 1800 N. Beauregard Street, Alexandria, VA 22311, USA., Department of Radiology, Columbia University Irving Medical Center, 622 W 168th St, New York, NY 10032, USA., Department of Radiology & Biomedical Imaging, Yale University School of Medicine, P.O. Box 208042, New Haven, CT 06520-8042, USA., Department of Radiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287, USA., Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street, Boston, MA 02118, USA.