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Abstract:

Introduction: the main indicator that determines the prognosis of cancer is the degree of prevalence of tumor process at the time of detection. In terms of the growth of primary morbidity among urological cancers, bladder cancer ranks third, and prostate cancer is second. Treatment of patients in advanced stages is palliative and aimed at improving the quality of life and increasing its duration.

Bleeding from the bladder or prostate in such cases is a life-threatening complication and one of the most common causes of death in advanced cancer.

Aim: was to evaluate the effectiveness of embolization of arteries of the bladder and prostate in cancer patients with bleeding from the lower urinary tract as a preparatory stage for the subsequent specialized therapy of the oncological process.

Materials and methods: from 2019 to August 2021, 38 embolizing interventions were performed in 36 patients with recurrent bleeding from the bladder with ineffective conservative hemostatic therapy. Of these, there were 30 men and 6 women. The average age was 63 ± 2,6 years. All patients at the prehospital stage were diagnosed with pelvic cancer with invasion of the bladder wall without the possibility of radical treatment. Particles with a size of 300-500 µm, embolization coils and fragmentated hemostatic sponge were used for embolization.

Results: immediate angiographic success in the form of stagnation of blood flow through the target arteries was achieved in 100% of operations. In most cases, the relief of macrohematuria was achieved at day 4 (average values of erythrocytes in urine are 3,66 in p/sp). 2 patients (5,6%) underwent a second endovascular intervention during hospitalization due to the many small afferents suppluying the bladder tumor from the a. pudenta interna. Bleeding stopped in these patients by the 8th day of hospital stay. The early postoperative period in 100% of patients was accompanied by mild postembolization syndrome, which was stopped by symptomatic therapy within 24 hours.

Conclusions: endovascular embolization in patients with oncopathology using the superselective technique has shown efficacy in stopping urological oncological bleeding, allows to achieve stable hemostasis in a short time and to continue specific treatment of cancer in patients of the 2nd clinical group.

  

References

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