Benign Prostatic Hyperplasia - New Treatment - Treatment

α-blockers and 5-reductase inhibitors are the first line therapy in men with symptomatic BPH. However, these medications are sometimes associated with sexual dysfunction.

Prostatectomy, that is the resection of the prostate, constitutes the traditional management of severe voiding difficulties secondary to BPH. However, this age group tends to be affected with comorbid cardiovascular diseases, therefore surgical interventions might be considered to be of high risk in many patients. Urinary tract infections, strictures, postoperative pain, incontinence or urinary retention, sexual dysfunction and blood loss are complications associated with surgical treatments.
Open surgery is less performed nowadays due to other treatment options. These include transurethral resection of the prostate (TURP), minimally invasive treatments (transurethral needle ablation and laser surgery) and prostatic stenting.
Minimally invasive treatments were originally conceived as an attempt to offer equivalent efficacy to transurethral resection without the risk of operative morbidity, with less blood loss, and lower risks of sexual side effects such as ejaculation disturbance and erectile dysfunction. However, they have major disadvantages such as less effective improvement in symptom score, greater risk of continued catheterization and reoperation and poorer durability of symptomatic benefit.
There is the need of innovative technologies to continue to improve outcomes and minimize patient discomfort and morbidity when managing BPH.
Embolization has been used mainly to control massive hemorrhage after prostatectomy.

Prostate embolization was performed by the first time by DeMerrit et al in 2000, in a 76 years old man with BPH who developed urinary retention and severe gross hematúria. The bleeding stopped immediately after embolization, the prostate volume decreased, the urinary symptoms improved and there were no changes in sexual function. In 2008 Carnevalle published 2 cases of sucessful embolization treated with urinay retention.
We published, in 1989, in the American journal of Radiology the Embolization in Uncontrollable Bleeding from pelvic tumors. The results of these cases suggest that prostate embolization might be an alternative treatment for symptomatic BPH. On the other hand we obtained excellent results with embolization of uterine fibroids in over 1300 women already treated.
These facts led us to investigate whether selective arterial prostatic embolization might be a feasible procedure as an alternative to surgery and minimally invasive treatment, with reduction of lower urinary tract symptoms associated with BPH.

The procedure was started on March 2009, on January 2014 – 600 patients were already treated.

The embolization of the prostate and of the uterine fibroid and all the radiologic intervention procedures are performed at St. Louis Hospital in Lisbon, by the team of Interventional Radiology, pioneer in Portugal, of those procedures that were introduced in 1980.

In the team there are Assistants Professors of Radiology, Anatomy and Urology and Catedratic Professor of Radiology.

Prostatic Artery Embolization is a new application of an old technology with old materials to a new clinical application, under investigation. Embolization has been successfully applied and accepted in Medicine for almost 50 years to different applications. Catheters, guide wires and the particles of polyvinyl alcohol have been successfully used in Medicine for over 50 years.

 

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Comentários: 9

  1. Mikhail Goginashvili says:

    Hello Mr.Martins Pisco! My name is Mikhail Goginashvili and I am 64 years old man. I’ve heard about your innovative treatment of BPH on tv news. I was diagnosed with BPH several years ago and since than I live very uncomfortable life. I was looking for doctors in Israel who was trained by you and can perform this procedure but I failed. Even more there is a some doctors who never heard about your new treatment. I am ready to come to your clinic and ready to be treated with this new procedure. Before that I was suggested to do the operation but since I found about you and your treatment I refused to do it. But time is runing against me. Would you be so kind to tell me how can I be treated by you in your clinic. I am ready to come to Portugal at any time you will tell me to. But as a foreign patient I don’t know the rules and regulation and the most important the way you can accept me as a patient. This is my Emails
    natoshka4548@yahoo.com
    giagio777@yahoo.com
    and my address in Israel
    45 Hahashmonaim Street, Apt# 7
    Bat-Yam, Israel 59496
    I would appreciate any answer and thank you in advance

    God Bless you

    With huge respect
    Mikhail Goginashvili

  2. seasign says:

    Endeavouring to get Dr Pisco’s clinic email contact
    Regards

  3. elizabetep says:

    Contacts are: 213216557 email martinspisco@hslouis.pt

  4. Anthony Greenaway says:

    Could you advise me of arrangements for having the treatment carried out in Lisbon as a private patirent.

  5. elizabetep says:

    You must make an appointment via email martinspisco@hslouis.pt.
    treatments are made Thursday but must make an Angio CT on Tuesday.

  6. Graeme says:

    Would you please advise whether there is anyone using Professor Pisco’s technique in Australia or New Zealand.
    Thank you.

  7. elizabetep says:

    Nobody in Australia or New Zealand

  8. juancarlos says:

    Hello, would you advise whether there is anyone using Prof.Pisco´s technique in Barcelona or Spain?
    Thank you

  9. Pina says:

    Hello,

    I do not know.

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