J Korean Soc Radiol.  2012 May;66(5):421-425. 10.3348/jksr.2012.66.5.421.

Superselective Embolization of the Inferior Vesical Artery for the Treatment of Intractable Hematuria from Pelvic Malignancy: Case Report

Affiliations
  • 1Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 2Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea. medmath@hanmail.net
  • 3Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Abstract

Intractable hematuria in from pelvic malignancy can be managed with conservative treatment in most patients. However, when treatment fails, surgical intervention may be required. Unfortunately, in most cases, the general condition of most patients is unfavorable for major surgery, with many patients having an inoperable status. We present two cases where intractable hematuria was successfully controlled by bilateral embolization of the inferior vesical artery with polyvinyl alcohol particles. Hematuria did not recur during the subsequent period and no complication was observed. Thus, bilateral embolization of the inferior vesical artery should be considered as an alternative method for the treatment of massive intractable hematuria caused by pelvic malignancy.


MeSH Terms

Arteries
Embolization, Therapeutic
Hematuria
Humans
Polyvinyl Alcohol
Prostatic Neoplasms
Urinary Bladder Neoplasms
Polyvinyl Alcohol

Reference

1. Choong SK, Walkden M, Kirby R. The management of intractable haematuria. BJU Int. 2000. 86:951–959.
2. Anand AK, Gupta SK, Ravi K, Ghosh D. Selective embolization of internal iliac artery for massive haemorrhage from bladder secondary to carcinoma. Clin Oncol (R Coll Radiol). 1991. 3:348–350.
3. Carmignani G, Belgrano E, Puppo P, Cichero A, Giuliani L. Transcatheter embilization of the hypogastric arteries in cases of bladder hemorrhage from advanced pelvic cancers: followup in 9 cases. J Urol. 1980. 124:196–200.
4. De Berardinis E, Vicini P, Salvatori F, Sciarra A, Gentile V, Di Silverio F. Superselective embolization of bladder arteries in the treatment of intractable bladder haemorrhage. Int J Urol. 2005. 12:503–505.
5. Delgal A, Cercueil JP, Koutlidis N, Michel F, Kermarrec I, Mourey E, et al. Outcome of transcatheter arterial embolization for bladder and prostate hemorrhage. J Urol. 2010. 183:1947–1953.
6. Hald T, Mygind T. Control of life-threatening vesical hemorrhage by unilateral hypogastric artery muscle embolization. J Urol. 1974. 112:60–63.
7. Kobayashi T, Kusano S, Matsubayashi T, Uchida T. Selective embolization of the vesical artery in the management of massive bladder hemorrhage. Radiology. 1980. 136:345–348.
8. Liguori G, Amodeo A, Mucelli FP, Patel H, Marco D, Belgrano E, et al. Intractable haematuria: long-term results after selective embolization of the internal iliac arteries. BJU Int. 2010. 106:500–503.
9. Nabi G, Sheikh N, Greene D, Marsh R. Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long-term follow-up. BJU Int. 2003. 92:245–247.
10. Rastinehad AR, Caplin DM, Ost MC, VanderBrink BA, Lobko I, Badlani GH, et al. Selective arterial prostatic embolization (SAPE) for refractory hematuria of prostatic origin. Urology. 2008. 71:181–184.
11. Gray H, Carter H. Gray's Anatomy: the Anatomical Basis of Clinical Practice. 2008. 40th ed. London: Churchill Livingstone.
12. Braf ZF, Koontz WW Jr. Gangrene of bladder. Complication of hypogastric artery embolization. Urology. 1977. 9:670–671.
13. Hietala SO. Urinary bladder necrosis following selective embolization of the internal iliac artery. Acta Radiol Diagn (Stockh). 1978. 19:316–320.
14. DeMeritt JS, Elmasri FF, Esposito MP, Rosenberg GS. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol. 2000. 11:767–770.
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