An unusual complication of prostatic arterial embolization: penile glans necrosis
DOI:
https://doi.org/10.48193/nhzv5327Keywords:
Prostate, Embolization, Necrosis, Glans, PenectomyAbstract
Clinical case description: the case of an 84-year-old male is presented, who developed penile glans necrosis over several days following prostatic arterial embolization. Due to the progression of the condition, a partial penectomy had to be performed for resolution.
Relevance: prostatic arterial embolization represents an effective approach for benign prostatic hyperplasia, although it is not without risks. As embolization of non-target areas is a very unusual but serious complication, there is a need of knowing and describing this kind of results.
Clinical implications: despite the unusual nature of penile glans necrosis, early recognition and diagnosis is crucial to prevent the worse outcomes. There are several clinical treatments before a surgical option that includes hyperbaric oxygen therapy or phosphodiesterase 5 inhibitors wich have a short opportunity window.
Conclusion: gland necrosis is a rare but serious condition that requires intensive and constant management to try to achieve its reversal. Ultimately, its treatment consists of partial or total penectomy.
References
Cornu JN, Gacci M, Hashim H, Herrmann TRW, Malde S, Netsch C, et al. EAU Guidelines on Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS). 2023.
Chung E. Penile Glans Necrosis following Prostatic Artery Embolization for the Treatment of Benign Prostatic Hyperplasia: A Rare but Serious Complication. Case Reports in Urology. 2021;2021: 6662899. https://doi.org/10.1155/2021/6662899.
Jung JH, McCutcheon KA, Borofsky M, Young S, Golzarian J, Reddy B, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews. 2020;12(12): CD012867. https://doi.org/10.1002/14651858.CD012867.pub2.
Naidu SG, Narayanan H, Saini G, Segaran N, Alzubaidi SJ, Patel IJ, et al. Prostate Artery Embolization-Review of Indications, Patient Selection, Techniques and Results. Journal of Clinical Medicine. 2021;10(21): 5139. https://doi.org/10.3390/jcm10215139.
A Pereira J, Bilhim T, Duarte M, Rio Tinto H, Fernandes L, Martins Pisco J. Patient selection and counseling before prostatic arterial embolization. Techniques in Vascular and Interventional Radiology. 2012;15(4): 270–275. https://doi.org/10.1053/j.tvir.2012.09.003.
Malling B, Røder MA, Brasso K, Forman J, Taudorf M, Lönn L. Prostate artery embolisation for benign prostatic hyperplasia: a systematic review and meta-analysis. European Radiology. 2019;29(1): 287–298. https://doi.org/10.1007/s00330-018-5564-2.
Knight GM, Talwar A, Salem R, Mouli S. Systematic Review and Meta-analysis Comparing Prostatic Artery Embolization to Gold-Standard Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia. Cardiovascular and Interventional Radiology. 2021;44(2): 183–193. https://doi.org/10.1007/s00270-020-02657-5.
Bhatia S. Meta-Analysis of Prostatic Artery Embolization for Benign Prostatic Hyperplasia-Review of 12-Month Outcomes Data. Journal of vascular and interventional radiology: JVIR. 2017;28(5): 772. https://doi.org/10.1016/j.jvir.2017.01.010.
Chung E. Penile Glans Necrosis Following Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Case Series and Review of Current Literature. The World Journal of Men’s Health. 2023;41(2): 396–402. https://doi.org/10.5534/wjmh.210244.
Parkin CJ, Pham C, Chung A, Menogue S, Catt J, Gottschalk G, et al. Non-Target Embolization of the Glans Penis during Prostatic Artery Embolization. Société Internationale d’Urologie Journal. 2021;2(5): 323–326. https://doi.org/10.48083/UCZQ9737.
Johnson-Arbor K, Field D. Use of hyperbaric oxygen therapy to treat glans penis necrosis after prostatic artery embolization. Urology Case Reports. 2022;45: 102237. https://doi.org/10.1016/j.eucr.2022.102237.
Montoya Martínez G, Otero García JM, López Samano V, González Martínez J, Serrano Brambila E. Necrosis de pene: Revisión de 18 casos en el Hospital de Especialidades Centro Médico nacional Siglo XXI. Archivos Españoles de Urología. 2006;59(6): 571–576.
Carnevale FC, Moreira AM, Antunes AA. The ‘PErFecTED technique’: proximal embolization first, then embolize distal for benign prostatic hyperplasia. Cardiovascular and Interventional Radiology. 2014;37(6): 1602–1605. https://doi.org/10.1007/s00270-014-0908-z.
Picel AC, Hsieh TC, Shapiro RM, Vezeridis AM, Isaacson AJ. Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Patient Evaluation, Anatomy, and Technique for Successful Treatment. Radiographics: A Review Publication of the Radiological Society of North America, Inc. 2019;39(5): 1526–1548. https://doi.org/10.1148/rg.2019180195.
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