Introduction: The purpose of this study was to evaluate the effectiveness and long-term results of selective transarterial iliac embolization (STIE) in patients with intractable bladder haemorrhage (IBH). Methods: Twenty-five patients with a median age of 84 (range 65–94) years underwent STIE because of IBH between 2002 and 2020. The median follow-up time was 3 (mean 13.9) months. Patients were treated because of bleeding bladder or prostate cancer, radiation-induced haemorrhagic cystitis, and other conditions. Success was defined as technical success (feasibility to embolize bilateral hypogastric arteries or neoplastic arteries) and as clinical success (absence of further or additional therapy). Results: Twenty-five patients with a median age of 84 years with a median hospital stay of 7 days were embolized at our institution. In total, 60% required additional therapy. Only 20% had minor complications, but no complication major was seen; 60% needed an additional therapy because of continuous bleeding. Our 30-day, 90-day, 6-month, and 12-month mortality rates were 28, 44, 64, and 76%, respectively. Conclusions: STIE in IBH is a safe, well-tolerated, and feasible procedure for palliating haematuria patients in poor general condition. Major complications are very rarely seen. However, patients often need additional therapy after STIE.

1.
Taha
DE
,
Shokeir
AA
,
Aboumarzouk
OA
.
Selective embolisation for intractable bladder haemorrhages: a systematic review of the literature
.
Arab J Urol
.
2018 Mar 2
;
16
(
2
):
197
205
. .
2.
Loffroy
R
,
Pottecher
P
,
Cherblanc
V
,
Favelier
S
,
Estivalet
L
,
Koutlidis
N
, et al.
Current role of transcatheter arterial embolization for bladder and prostate hemorrhage
.
Diagn Interv Imaging
.
2014 Nov
;
95
(
11
):
1027
34
.
Epub 2014 Apr 18. Review
. .
3.
Abt
D
,
Bywater
M
,
Engeler
DS
,
Schmid
HP
.
Therapeutic options for intractable hematuria in advanced bladder cancer
.
Int J Urol
.
2013 Jul
;
20
(
7
):
651
60
.
Epub 2013 Feb 6
. .
4.
Lodde
M
,
Palermo
S
,
Comploj
E
,
Signorello
D
,
Mian
C
,
Lusuardi
L
, et al.
Four years experience in bladder preserving management for muscle invasive bladder cancer
.
Eur Urol
.
2005 Jun
;
47
(
6
):
773
9
.
discussion 778–9. Epub 2005 Feb 10
. .
5.
Pycha
A
,
Palermo
S
,
Trenti
E
,
Ladurner
C
,
Mian
M
,
Bonatti
M
, et al.
Quality of life in patients with invasive bladder cancer who cannot undergo cystectomy
.
Expert Rev Qual Life Cancer Care
.
2016
;
1
(
4
):
339
45
. .
6.
Adult Comorbidity Evaluation-27 (ACE-27) Comorbidity Scores Cancer. Available from
: https://www.medicalalgorithms.com/comorbidity-scores-cancer.
7.
Korkmaz
M
,
Şanal
B
,
Aras
B
,
Bozkaya
H
,
Çınar
C
,
Güneyli
S
, et al.
The short- and long-term effectiveness of transcatheter arterial embolization in patients with intractable hematuria
.
Diagn Interv Imaging
.
2016 Feb
;
97
(
2
):
197
201
.
Epub 2015 Oct 23
. .
8.
Hald
T
,
Mygind
T
.
Control of life-threatening vesical hemorrhage by unilateral hypogastric artery muscle embolization
.
J Urol
.
1974 Jul
;
112
(
1
):
60
3
. .
9.
Delgal
A
,
Cercueil
JP
,
Koutlidis
N
,
Michel
F
,
Kermarrec
I
,
Mourey
E
, et al.
Outcome of transcatheter arterial embolization for bladder and prostate hemorrhage
.
J Urol
.
2010 May
;
183
(
5
):
1947
53
.
Epub 2010 Mar 19
. .
10.
Loffroy
R
,
Guiu
B
,
Cercueil
JP
,
Krausé
D
.
Endovascular therapeutic embolisation: an overview of occluding agents and their effects on embolised tissues
.
Curr Vasc Pharmacol
.
2009 Apr
;
7
(
2
):
250
63
. .
11.
Nabi
G
,
Sheikh
N
,
Greene
D
,
Marsh
R
.
Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long-term follow-up
.
BJU Int
.
2003 Aug
;
92
(
3
):
245
7
. .
12.
Liguori
G
,
Amodeo
A
,
Mucelli
FP
,
Patel
H
,
Marco
D
,
Belgrano
E
, et al.
Intractable haematuria: long-term results after selective embolization of the internal iliac arteries
.
BJU Int
.
2010 Aug
;
106
(
4
):
500
3
.
Epub 2010 Jan 29
. .
13.
Osmonov
DK
,
Aksenov
AV
,
Naumann
CM
,
Jünemann
KP
.
[A serious complication after bladder embolisation due to massive tissue necrosis in the gluteal region]
.
Aktuelle Urol
.
2014 Jan
;
45
(
1
):
50
3
.
Epub 2014 Feb 5
. .
14.
Appleton
DS
,
Sibley
GN
,
Doyle
PT
.
Internal iliac artery embolisation for the control of severe bladder and prostate haemorrhage
.
Br J Urol
.
1988 Jan
;
61
(
1
):
45
7
. .
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.