前立腺肥大症治療のための前立腺動脈塞栓術。1,000人以上の治療患者を対象としたロシアの多施設研究

Prostatic Artery Embolization for Benign Prostatic Hyperplasia Treatment: A Russian Multicenter Study in More Than 1,000 Treated Patients.

• Armais Kamalov
• Sergei Kapranov
• Alexander Neymark
• Dmitry Kurbatov
• Boris Neymark
• Valery Karpov
• Boris Shaparov

抄録

良性前立腺肥大症（BPH）は、泌尿器系の疾患の中で最も一般的なものの一つである。BPHの有病率は、年齢が上がるにつれて男性で増加する。経尿道的前立腺切除術では、逆行性射精、尿失禁、血尿、尿道絞扼、膀胱頸部硬化症などの合併症を伴うが、前立腺動脈の超選択的塞栓術（PAE）、特にProximal Embolization First Then Distal Embolization（PErFecTED）などの低侵襲手術法を適用する必要がある。血管内手術を受けた BPH 患者 1,015 例のデータから、手術後 24 ヵ月間の PErFecTED 治療の有益性が実証された。生活の質（QOL）スコア、国際前立腺症状スコアともにPErFecTED群で約3倍改善し、全観察期間中も安定していた。ただし、術後塞栓症候群のリスクが高いため、術式の改善が必要とされている。

Benign prostatic hyperplasia (BPH) is one of the most common diseases of the genitourinary system. The prevalence of BPH increases in men with advancing age. While transurethral resection of the prostate gland entails complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck sclerosis, and other adverse events, it is necessary to apply minimally invasive surgical methods such as superselective embolization of the prostatic arteries (PAE), particularly Proximal Embolization First Then Distal Embolization (PErFecTED). The data from 1,015 BPH patients who underwent endovascular surgery demonstrate the benefits of PErFecTED treatment during 24 months after surgery. Both Quality of Life score and International Prostate Symptom Score were around three times better in the PErFecTED group and remained stable during the entire observation period. However, the technique needs to be improved due to the high risk of postembolization syndrome.