Terumo India Skill Lab’s Post

Transcript

What is prostatic artery embolization and when is it needed? Prostate artery embolization is a novel and effective procedure for patients suffering from benign prostatic hyperplasia. That's BPH. So first of all, we should know what is embolization? Embolization meaning to stop or to block the arterial supply of any organ or the part of body or we can. Some tumor with the help of sand lake or salt like calibrated particle with the help of microcatheter. So if we talk about the prostatic artery, so those patients, those who are suffering from benign prostatic hyperplasia, in those patients, first of all, we do angiography of prostatic artery and with the help of microcatheter and super selectively we go into the prostatic artery branches and we do embolization for those artery. And all those symptoms of BPH patient, they are relieved within. Four weeks next question was that when is it needed? So as I have already mentioned, all the patient those who are suffering from benign prostatic hyperplasia and lower urinary tract symptoms, for those patient prostatic artery embolization is very safe and effective method for treatment. What are the advantages of prostatic artery embolization over conventional modality of management after diagnosing BPH? Previously there were only two kinds of treatment method. And husband was medication so like alpha adrenergic blockers and 5A reductase inhibitor, phosphodiesterase 5 inhibitor. But those medications they had their own side effect like hypertension, headache, dizziness, erectile dysfunction, ejaculatory dysfunction and then surgery came into the picture. So there are different, different kind of surgery like UBUIP hydrodissection, laser vaporization or some sort of clipping and stapling. But again those procedures that they have intra op and post op complications. So and they also have pride effects. So between these two treatment modality, we have one very advanced safe and effective treatment option which is a prostate artery embolization. And the beauty of this procedure that we do not need any kind of general anesthesia, no cut, no structure, no incision, no bleeding. And the present literature evidence on this procedure, there are multiple prospective case series, randomized controlled trials and meta analysis. So if we talk about some, there are prospective case series or randomized control trial especially by NIH. And there are several articles on Pub Med and Radiological Society of North America. So as per the randomized control trial, if we compare TU RP with prostate artery embolization, so the clinical success rate is almost 100%. For both the professors and if we talk about the complication, they're definitely there is 56% ejaculatory dysfunction which is temporary with prostate artery embolization while 84% in TURP surgery and the IPSS score which is international prostate symptom is 4. The quality of life index, the Qmax rate which is the maximum urinary flow rate. So there is no marginal difference between these two professors at 12 month success rate is almost 85% thirty month success rate. 84% while 78 month success rate is 76% in prostate artery embolization. What is radial approach and its benefit for the patients? Nowadays we take radial artery puncture at risk with the help of ultrasound guidance and from radial artery approach we goes to the prostate artery and we do angiography there and then embolization of course. So we have specialized hardware and Riddle artery approach as a doctor point of view. It makes procedure very easy for me. And there is less radiation for me and my patient, it is less time consuming as compared to femoral artery. There are few side effects or complications associated with femoral artery puncture like they're candy groin, hematoma and in rare cases there can be sudal aneurysm formation. But if we talk about radial artery, so definitely it is better than femoral artery because we can ambulate patient immediately after procedure, patient can take care of himself and definitely we can discharge patient on. Same day patient need not to lie down on bed for a longer time and definitely patient can get back to work after two or three days. What is your message to the general physicians for patient management in their OPD post procedure? After doing prostate artery embolization, patient might complain of some initial or mild symptoms like burning, retropubic pain and their acute urinary incontinence. So such kind of mild symptoms should be addressed by the physician or the. And we should just start some medication, patient require urinary catheter in acute urinary incontinence. So at around one to two weeks we can remove those catheter And follow up is very simple, one week, two week, three-week, four week. And there after three months, six months, one year and then yearly follow up. The follow up is very important and mental satisfaction is very, very important for patient. So the physician sympathy towards. Shank is very important.