Urinary Bladder Ischemia Post-Prostate Artery Embolization: Conservative Treatment

Background: Several treatments are available for BPH, including medications and surgical. Recently, prostate artery embolization (PAE) has emerged as an alternative minimally invasive treatment option for LUTS due BPH with the advantages of high safety, minor complications and short recovery.

Case: A 78-year-old male patient who has long-standing BPH symptoms with moderate IPSS of 18 that made him mostly dissatisfied. Two weeks postembolization, the patient presented to the ER, complaining of severs suprapubic pain and dysuria. Following a discussion on his condition enhanced CT scan of the pelvis was performed showing unenhanced segment within the right-sided of the urinary bladder wall worrisome for urinary bladder ischemia. Based on CT scan and cystoscopy findings, decision was made to treat the patient conservatively as the best option available. Therefore, foley catheter was inserted and kept for 3 weeks during which the patient was kept on Bactrim, Vesicare, and Paracetamol on demand. After 3 weeks the patient's symptoms improved then follow-up.

Discussion: There is no specific therapeutic option in the treatment of urinary bladder ischemia after PAE. Bacterial infection may occur after ischemia in the bladder; therefore, antibiotic treatment is recommended once ischemia has been confirmed by either CT scan or cystoscopy.

Publication History

Article published online:
09 February 2023