Track topics on Twitter Track topics that are important to you
Abstract Background and Purpose: Severe postoperative bleeding after radical prostatectomy is a rare, but serious, complication. Massive postoperative bleeding causing hemodynamic instability necessitates open surgical exploration and can be associated with considerable morbidity. We report our experience with minimally invasive management of postprostatectomy hemorrhage via transarterial embolization (TAE). Patients and Methods: From July 2006 to April 2009, men with severe immediate postoperative bleeding that caused hemodynamic instability after radical prostatectomy were enrolled. We performed emergency angiography and superselective TAE instead of surgical exploration as the initial management. TAE was performed using an enbucrilate:ethiodized poppy seed oil 1:3 mixture. We determined treatment success rate, efficacy, and safety. Results: A total of 4 among 563 (0.7%) patients had postoperative bleeding that fit the inclusion criteria in this period. CT angiography revealed active bleeding in all cases. All patients were successfully treated with TAE without any additional treatment, such as surgical exploration, and there was no treatment-related adverse event. Three (75%) patients regained continence within 6 months. Two (50%) patients were potent at 12-month follow-up. Conclusion: During a 3-year period, we successfully treated all patients who had severe immediate postoperative bleeding after radical prostatectomy with TAE. We concluded that rapid diagnosis by CT angiography and early TAE could replace surgical exploration in this situation. In addition, this could minimize the morbidity associated with severe bleeding, transfusion, and open surgical exploration.
Department of Urology, Seoul National University Hospital , Seoul, Korea.
This article was published in the following journal.
Name: Journal of endourology / Endourological Society
Robotic-assisted radical prostatectomy (RALP) is a minimally invasive procedure that could have a reduced learning curve for unfamiliar laparoscopic surgeon. However, there are no consensuses regardin...
Interbody fusion is the gold standard treatment for the management of numerous diseases of the spine. Minimally invasive techniques may be more beneficial than conventional techniques. The main goal o...
Recently a retrospective study has been published describing a significant correlation of immediate postoperative leukocytosis (IPLC) and a favorable pathological Gleason score (pGS) in patients under...
Urinary continence is a driver of quality of life after radical prostatectomy. The purpose of this study was to evaluate the impact of a biologic bladder neck sling on postoperative return of urinary ...
The minimally invasive posterior cervical foraminotomy procedure has become a common and successful procedure for the treatment of cervical radiculopathy. Specifically, the minimally invasive approach...
Prospective randomized study performing open anterograde anatomical radical retropubic prostatectomy (RRP2A) using the same technique of minimally invasive surgery described by the Pasaden...
Our objective is to evaluate the clinical outcomes for the anatomic radical perineal prostatectomy (RPP) for the surgical management of prostate cancer. We will report the perioperative, ...
Neurovascular bundle (NVB) contains capsular vessels to the prostate and cavernous nerves that provides the macroscopic landmark used during nerve-sparing radical prostatectomy. The preser...
This study is evaluating the effect of a Belladonna and Opium suppository administered intraoperatively on post operative pain after laparoscopic radical prostatectomy for prostate cancer....
Prostate Cancer Intervention Versus Observation Trial (PIVOT):A Randomized Trial Comparing Radical Prostatectomy Versus Palliative Expectant Management for the Treatment of Clinically Localized Prostate Cancer
Radical prostatectomy provides potentially curative removal of the cancer. However, it subjects patients to the morbidity and mortality of the surgery and may be neither necessary nor effe...
Procedures that avoid use of open invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. With the reduced trauma associated with minimally invasive surgery, long hospital stays may be reduced with increased rates of short stay or day surgery.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY.
Minimally invasive procedures guided with the aid of magnetic resonance imaging to visualize tissue structures.
The univalent radical OH. Hydroxyl radical is a potent oxidizing agent.
Prostate cancer (cancer de prostata) Prostate cancer (cancer de prostata) is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostat...
Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...