metricas
covid
Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Prostatic artery embolization treatment for patients with benign prostatic hyper...
Journal Information

Statistics

Follow this link to access the full text of the article

Original article
Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery
Embolización prostática como tratamiento para pacientes con hiperplasia benigna de próstata portadores de sonda vesical permanente no tributarios a cirugía desobstructiva
D. Salvador Hidalgoa,
Corresponding author
, M. Bernardello Uretaa, M. Sbriglioa, A. García Gámezb, J. Sampere Moragasb, J. Areal Calamaa, F. Ágreda Castañedaa
a Servicio de Urología, Hospital Germans Trias i Pujol, Barcelona, Spain
b Servicio de Radiología Intervencionista, Hospital Germans Trias i Pujol, Barcelona, Spain
Read
2
Times
was read the article
0
Total PDF
2
Total HTML
Share statistics
 array:24 [
  "pii" => "S2173578621000834"
  "issn" => "21735786"
  "doi" => "10.1016/j.acuroe.2021.06.008"
  "estado" => "S300"
  "fechaPublicacion" => "2021-09-01"
  "aid" => "1373"
  "copyright" => "AEU"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Actas Urol Esp. 2021;45:481-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S021048062100084X"
      "issn" => "02104806"
      "doi" => "10.1016/j.acuro.2021.04.001"
      "estado" => "S300"
      "fechaPublicacion" => "2021-09-01"
      "aid" => "1373"
      "copyright" => "AEU"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Actas Urol Esp. 2021;45:481-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Art&#237;culo original</span>"
        "titulo" => "Embolizaci&#243;n prost&#225;tica como tratamiento para pacientes con hiperplasia benigna de pr&#243;stata portadores de sonda vesical permanente no tributarios a cirug&#237;a desobstructiva"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "481"
            "paginaFinal" => "485"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "D&#46; Salvador Hidalgo, M&#46; Bernardello Ureta, M&#46; Sbriglio, A&#46; Garc&#237;a G&#225;mez, J&#46; Sampere Moragas, J&#46; Areal Calama, F&#46; &#193;greda Casta&#241;eda"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Salvador Hidalgo"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Bernardello Ureta"
              ]
              2 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Sbriglio"
              ]
              3 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Garc&#237;a G&#225;mez"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Sampere Moragas"
              ]
              5 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Areal Calama"
              ]
              6 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "&#193;greda Casta&#241;eda"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173578621000834"
          "doi" => "10.1016/j.acuroe.2021.06.008"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578621000834?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048062100084X?idApp=UINPBA00004N"
      "url" => "/02104806/0000004500000007/v1_202109020754/S021048062100084X/v1_202109020754/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173578621000822"
    "issn" => "21735786"
    "doi" => "10.1016/j.acuroe.2021.06.007"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "1371"
    "copyright" => "AEU"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Actas Urol Esp. 2021;45:486-92"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "How does puncture modality affect the risk of intraoperative bleeding during percutaneous nephrolithotomy&#63; A prospective randomized trial"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "486"
          "paginaFinal" => "492"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "&#191;C&#243;mo afecta la t&#233;cnica de punci&#243;n al riesgo de sangrado intraoperatorio durante la nefrolitotom&#237;a percut&#225;nea&#63; Ensayo aleatorizado prospectivo"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Sahan, A&#46; Cubuk, O&#46; Ozkaptan, K&#46; Ertas, T&#46; Toprak, B&#46; Eryildirim, K&#46; Sarica"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Sahan"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Cubuk"
            ]
            2 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Ozkaptan"
            ]
            3 => array:2 [
              "nombre" => "K&#46;"
              "apellidos" => "Ertas"
            ]
            4 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Toprak"
            ]
            5 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Eryildirim"
            ]
            6 => array:2 [
              "nombre" => "K&#46;"
              "apellidos" => "Sarica"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210480621000826"
        "doi" => "10.1016/j.acuro.2020.10.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480621000826?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578621000822?idApp=UINPBA00004N"
    "url" => "/21735786/0000004500000007/v1_202109020840/S2173578621000822/v1_202109020840/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173578621000810"
    "issn" => "21735786"
    "doi" => "10.1016/j.acuroe.2021.06.006"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "1369"
    "copyright" => "AEU"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "edi"
    "cita" => "Actas Urol Esp. 2021;45:479-80"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Surgery for oligometastatic prostate cancer&#58; Where are we going&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "479"
          "paginaFinal" => "480"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Cirug&#237;a del c&#225;ncer de pr&#243;stata oligometast&#225;sico&#58; &#191;hacia d&#243;nde nos dirigimos&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Alvarez-Maestro, J&#46; Gomez Rivas, M&#46; Moschini"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Alvarez-Maestro"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gomez Rivas"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Moschini"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578621000810?idApp=UINPBA00004N"
    "url" => "/21735786/0000004500000007/v1_202109020840/S2173578621000810/v1_202109020840/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "481"
        "paginaFinal" => "485"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Salvador Hidalgo, M&#46; Bernardello Ureta, M&#46; Sbriglio, A&#46; Garc&#237;a G&#225;mez, J&#46; Sampere Moragas, J&#46; Areal Calama, F&#46; &#193;greda Casta&#241;eda"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Salvador Hidalgo"
            "email" => array:2 [
              0 => "dsalvadorhidalgo@gmail.com"
              1 => "dsalvador.germanstrias@gencat.cat"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Bernardello Ureta"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Sbriglio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Garc&#237;a G&#225;mez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Sampere Moragas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Areal Calama"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "&#193;greda Casta&#241;eda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Urolog&#237;a&#44; Hospital Germans Trias i Pujol&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Radiolog&#237;a Intervencionista&#44; Hospital Germans Trias i Pujol&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Embolizaci&#243;n prost&#225;tica como tratamiento para pacientes con hiperplasia benigna de pr&#243;stata portadores de sonda vesical permanente no tributarios a cirug&#237;a desobstructiva"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Lower urinary tract symptoms &#40;LUTS&#41; arise as a result of different factors&#46; Infravesical obstruction is among the most frequent causes and&#44; specifically&#44; benign prostatic hyperplasia is considered the most common cause&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> LUTS&#44; which involve high healthcare costs&#44; are strongly associated with aging and are therefore likely to increase with future demographic changes&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Urgent treatment in patients with acute urinary retention consists of bladder catheterization&#46; Bladder catheterization is associated with high comorbidity and mortality &#40;bacterial colonization&#44; recurrent infections&#44; antibiotic resistance&#44; sepsis&#44; bladder stones&#44; etc&#46;&#41; consequently decreasing the patients&#8217; quality of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> At least one attempted trial of voiding after catheter removal is recommended &#40;once the patient is under appropriate medical treatment&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Surgery for prostatic obstruction is the treatment of choice in patients without contraindications who do not achieve spontaneous micturition after catheter removal&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Surgery is the treatment of choice in those patients in whom medical treatment fails&#46; However&#44; there is a high percentage of patients with significant comorbidities or advanced age who are ineligible for surgery&#46; In this group&#44; the only option available is to maintain an indwelling urinary catheter and undergo regular changes&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Prostatic artery embolization &#40;PAE&#41; is an interventional radiological technique involving the injection of calibrated particles directly into the prostatic arteries&#44; leading to devascularization&#44; ischemia and prostate gland reduction&#46; This procedure is becoming a progressively recognized therapeutic alternative in the treatment of LUTS secondary to benign prostatic hyperplasia&#46; There is increasing evidence that it is a safe&#44; effective and innovative option against other invasive therapies&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> Specifically&#44; PAE is presented as a rescue therapy in patients in whom medical treatment has failed and have limited or no therapeutic alternative&#58; it has been successfully performed in patients with urinary retention and indwelling bladder catheterization and in those who reject the risks of surgical intervention&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; PAE can be an effective treatment to avoid indwelling bladder catheterization in ineligible patients due to advanced age&#44; cardiovascular disease or other comorbidities&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In this retrospective study&#44; we evaluated the efficacy of PAE in indwelling urinary catheter users who are ineligible for surgical treatment&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient selection</span><p id="par0035" class="elsevierStylePara elsevierViewall">Retrospective study with a total of 26 indwelling bladder catheter users with associated comorbidities&#44; ineligible for surgical treatment&#44; who underwent prostatic arterial embolization&#46; Demographic &#40;age&#44; previous pathologies&#41; and clinical features &#40;PSA&#44; indwelling catheterization time&#44; prostate volume&#44; medication for LUTS management&#44; anticoagulation&#44; hospitalization time&#41;&#44; Charlson comorbidity index assessment and Clavien-Dindo classification for surgical complications were reviewed&#46; Due to the prognostic value associated with comorbidity and the need to use an instrument to separate the effect of comorbidity from other factors&#44; different comorbidity indexes have been created&#44; including the Charlson index&#44; which relates long-term mortality to patient comorbidity&#46; Globally&#44; no comorbidity is considered 0&#8211;1 point&#44; low comorbidity 2 points and high comorbidity more than 3 points&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Median and interquartile range were used to describe continuous variables and percentage for nominal variables&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedure</span><p id="par0040" class="elsevierStylePara elsevierViewall">All patients suitable to prostatic embolization underwent prior computed tomography angiography &#40;CT angiography&#41;&#46; The purpose of CT angiography is to assess the feasibility of femoral access&#44; evaluate the permeability of the aorta and iliac arteries&#44; check if they are very tortuous or calcified&#44; since these factors increase the technical difficulty&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> It is also useful in the evaluation of vascular and morphological characteristics of the prostate&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Prostatic arterial embolization was performed by the interventional radiology service of our center&#46; A 5 Fr pig-tail catheter was advanced into the distal aorta&#44; after puncture of the right common femoral artery&#44; with pelvic arteriogram to map the origin of the prostatic arteries and possible connections with hemorrhoidal&#44; vesical or penile arteries&#46; The aim was to avoid possible complications caused by non-target embolization&#46; Calibrated particles or microspheres can be used to seal such dangerous connections&#46; Calibrated 400&#8239;&#181;s particles &#40;Embozene&#174;&#41; were used for embolization&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">When prostatic arterial stasis is achieved and devascularization of the gland is verified&#44; embolization is terminated&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Postoperative follow-up</span><p id="par0055" class="elsevierStylePara elsevierViewall">Patients were followed in a conventional urology ward&#46; The first attempt to remove the urinary catheter was performed one month after the procedure&#46; Once the catheter was removed&#44; spontaneous micturition and postvoid residual &#40;PVR&#41; were evaluated&#46; Success was considered if PVR was less than 100&#8239;mL and the patient did not present a new episode of acute urinary retention&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The global description of the population can be seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; A total of 26 patients were included in the analysis&#46; The median age of patients was 85 years &#40;interquartile range&#58; 79&#8722;88&#41;&#44; with a median prostate volume of 90&#8239;mL &#40;interquartile range&#58; 72&#8722;112&#41;&#46; Patients&#8217; PSA was measured before embolization&#44; with a median of 3&#46;18&#8239;ng&#47;mL &#40;interquartile range&#58; 1&#46;8&#8722;5&#46;1&#41;&#46; Of all 26 patients&#44; 11 &#40;42&#46;3&#37;&#41; were taking antiplatelet drugs and 3 &#40;11&#46;5&#37;&#41; were taking anticoagulants&#46; Regarding the Charlson Comorbidity Index&#44; 88&#46;5&#37; of the subjects scored more than 7&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Bilateral prostatic arterial embolization was achieved in 20 of the 26 patients &#40;76&#46;9&#37;&#41; and unilateral embolization was achieved in 6 patients &#40;23&#46;1&#37;&#41;&#44; due to the impossibility of selective catheterization of the prostatic artery on one side&#46; In 25 of the 26 subjects &#40;96&#46;2&#37;&#41;&#44; hospitalization time was 24&#8239;h&#46; Severe stenosis of the prostatic arteries was identified in one case after angio-CT&#44; and embolization was discouraged &#40;not included in the analysis&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Complications were measured according to the Clavien-Dindo classification &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; A total of 6 of the 26 patients had complications after the procedure&#44; 2 patients had grade I complications in the Clavien-Dindo classification &#40;urinary retention after bladder catheter removal&#41;&#44; 3 patients had grade II complications &#40;urinary tract infection with positive culture requiring antibiotic treatment&#41; and 1 patient had grade III complications &#40;bladder rupture after traumatic manual bladder irrigation&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The first attempt to remove the catheter was made 30 days after embolization&#46; In the first attempt&#44; 17 of the 26 subjects &#40;65&#46;4&#37;&#41; achieved spontaneous micturition and a PVR lower than 100&#8239;mL &#40;categorized as success&#41;&#46; Of the remaining 9 subjects&#44; 4 refused another attempt to remove the catheter&#46; Of the remaining 5&#44; removal of the indwelling urinary catheter was achieved at 60 and 90 days in 2 patients&#46; In total&#44; catheter removal was achieved in 19 of the 26 subjects &#40;73&#46;1&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Statistical analysis by multiple regression could not demonstrate clinical factors associated with treatment failure&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Despite advances in the surgical treatment for the management of urinary tract symptoms secondary to benign prostatic hyperplasia&#44; there are patients in whom conventional surgery cannot be performed due to frailty or significant comorbidities&#46; New techniques with a less invasive approach and satisfactory results have been investigated for years&#46; Prostatic urethral lift or botulinum toxin injection are some of the proven alternatives to surgical treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;14</span></a> Another minimally invasive option which does not require general anesthesia is iTIND&#174;&#44; currently under investigation&#46; This procedure involves temporary implanted nitinol in the prostatic urethra using a cystoscope&#46; The device is removed after 5 days&#46; It has shown good functional outcomes and urodynamic parameters but has not been tested in patients with indwelling urinary catheters&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Prostatic arterial embolization has inherent advantages over traditional surgical therapies&#46; First&#44; these procedures are generally performed through femoral artery access under conscious sedation rather than general anesthesia&#46; Second&#44; unlike more invasive procedures&#44; PAE can be done on an outpatient basis or in a very short hospitalization time&#46; And finally&#44; there does not seem to be a prostate volume upper limit that may make PAE ineffective&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Evidence from short- and medium-term data on PAE indicates that this evolving technology can be used in large prostates without additional risks of adverse events&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Our study reports catheter removal success rates after prostatic embolization of 73&#37;&#46; These results are comparable to those from recent studies&#58; Rampoldi et al&#46; reported a bladder catheter removal rate of 75&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> bilateral prostatic embolization rate of 76&#37; and complication rates similar to ours&#46; In their publication&#44; multiple regression was unable to determine factors associated with treatment failure&#59; the factor with more significance was unilateral &#40;vs&#46; bilateral&#41; embolization&#46; This indicates that the effectiveness of PAE depends on the degree of devascularization of the adenoma&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">It was not possible to calculate predictors of PAE failure&#47;success in our series&#46; In the 21&#37; of subjects in whom bilateral embolization was not achieved&#44; the most frequent cause was severe arteriosclerosis&#44; a previously described phenomenon and with similar rates&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;16</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Complications of PAE result from nonselective embolization of pelvic arteries &#40;of colic or rectal&#44; penile or bladder arteries&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a> They are usually mild and do not require hospitalization or surgery&#46; There was only one grade III Clavien-Dindo complication in our series&#58; a patient with hematuria after PAE who&#44; as a consequence of vigorous manual bladder irrigation&#44; presented an intraperitoneal bladder rupture that required urgent repair&#46; There was no evidence of bladder ischemia during surgery and the primary suture progressed adequately&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our study has a number of limitations&#46; Despite the success rate of bladder catheter removal and a satisfactory PVR&#44; functional improvement was not assessed with urodynamic tests or validated questionnaires&#46; Nor were imaging studies performed to demonstrate the decrease in prostate volume&#46; These limitations are a consequence of the functional status of all the patients included&#58; elderly and with high comorbidities &#40;88&#37; of patients with a Charlson comorbidity index greater than 7&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0110" class="elsevierStylePara elsevierViewall">PAE is a safe and effective procedure in the treatment of indwelling bladder catheter users with comorbidities that preclude conventional surgical techniques&#46; Even so&#44; prospective studies and ancillary tests following PAE are necessary to determine the place that this technique will occupy within the broad collection of options for the treatment of prostate-related bladder outlet obstruction&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1567342"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1412264"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1567343"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1412263"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patient selection"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Procedure"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Postoperative follow-up"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-12-08"
    "fechaAceptado" => "2021-04-02"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1412264"
          "palabras" => array:4 [
            0 => "Benign prostatic hyperplasia"
            1 => "Prostatic embolization"
            2 => "Lower urinary tract symptoms"
            3 => "Benign prostatic hyperplasia treatment"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1412263"
          "palabras" => array:4 [
            0 => "Hiperplasia prost&#225;tica benigna"
            1 => "Embolizaci&#243;n prost&#225;tica"
            2 => "S&#237;ntomas del tracto urinario inferior"
            3 => "Tratamiento de hiperplasia benigna de pr&#243;stata"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Benign prostatic hyperplasia is considered the most frequent cause of lower urinary tract symptoms&#46; Urinary catheterization is the emergency treatment for patients with urinary retention and surgery is indicated in patients refractory to medical treatment&#46; There is a group of people with important comorbidities that make them ineligible for surgery&#46; Prostatic arterial embolization &#40;PAE&#41; could be presented as a safe and effective alternative to achieve bladder emptying and spontaneous urination&#44; thus avoiding permanent urinary catheterization in patients with significant comorbidities that represent a contraindication for surgery&#46; In this retrospective study&#44; we evaluated the efficacy of PAE in patients with permanent urinary catheterization who are ineligible for surgical treatment&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of 26 patients with permanent urinary catheter who underwent prostatic embolization&#46; Demographic and clinical data &#40;age&#44; use of anticoagulation&#44; prostate volume&#44; length of hospital stay&#44; unilateral or bilateral embolization&#41;&#44; Charlson comorbidity index evaluation and Clavien-Dindo classification for procedural complications were reviewed&#46; Successful removal of permanent urinary catheter was analyzed at one month after the procedure&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 26 patients were included in the review&#46; The median age was 85 years with a median prostate volume of 90 mL&#46; A Charlson comorbidity score above 7 was obtained in 88&#46;5&#37; of the subjects&#46; Only one patient had one Clavien-Dindo III complication&#46; Of the 26 subjects&#44; 17 &#40;65&#46;4&#37;&#41; had spontaneous micturition and a postvoid residual lower than 100&#8239;mL at one month post procedure&#46; Overall&#44; catheter removal was achieved in 19 out of 26 subjects &#40;73&#46;1&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">PAE is a safe and effective treatment for patients with permanent urinary catheterization who are ineligible for surgical treatment&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La hiperplasia benigna de pr&#243;stata se considera la causa m&#225;s com&#250;n de los s&#237;ntomas del tracto urinario inferior&#46; El sondaje vesical es el tratamiento urgente en pacientes con retenci&#243;n urinaria y la cirug&#237;a el de aquellos refractarios al tratamiento m&#233;dico&#46; Existe un grupo de personas con comorbilidades importantes no tributarias a cirug&#237;a&#46; La embolizaci&#243;n arterial prost&#225;tica &#40;EAP&#41; podr&#237;a presentarse como una alternativa segura y eficaz para conseguir el vaciamiento vesical y la micci&#243;n espont&#225;nea&#44; evitando as&#237; el sondaje vesical permanente en pacientes con comorbilidades importantes que contraindiquen la cirug&#237;a&#46; En este estudio retrospectivo&#44; evaluamos la eficacia de la EAP en pacientes portadores de sonda vesical permanente no tributarios de tratamiento quir&#250;rgico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de 26 pacientes portadores de sonda vesical permanente a los que se les realiz&#243; una embolizaci&#243;n prost&#225;tica&#46; Se revisaron los datos demogr&#225;ficos y cl&#237;nicos &#40;edad&#44; uso de anticoagulaci&#243;n&#44; volumen prost&#225;tico&#44; tiempo de ingreso&#44; embolizaci&#243;n unilateral o bilateral&#41;&#44; la evaluaci&#243;n del &#237;ndice de comorbilidad de Charlson y la clasificaci&#243;n de Clavien-Dindo para las complicaciones del procedimiento&#46; Se analiz&#243; el &#233;xito de la retirada de la sonda vesical permanente al mes del procedimiento&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Un total de 26 pacientes fueron incluidos en la revisi&#243;n&#46; La mediana de edad fue de 85 a&#241;os&#44; con un volumen prost&#225;tico mediano de 90 mL&#46; El 88&#44;5&#37; de los sujetos puntu&#243; m&#225;s de 7 en la escala de comorbilidad de Charlson&#46; Un &#250;nico paciente present&#243; una complicaci&#243;n Clavien-Dindo III&#46; De los 26 sujetos&#44; 17 &#40;65&#44;4&#37;&#41; tuvieron una micci&#243;n espont&#225;nea y un residuo posmiccional inferior a 100 mL al mes del procedimiento&#46; En total&#44; se logr&#243; retirar la sonda vesical en 19 de los 26 sujetos &#40;73&#44;1&#37;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La EAP es un procedimiento seguro y eficaz en el tratamiento de pacientes con sondaje vesical permanente no tributarios de tratamiento quir&#250;rgico&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Salvador Hidalgo D&#44; Bernardello Ureta M&#44; Sbriglio M&#44; Garc&#237;a G&#225;mez A&#44; Sampere Moragas J&#44; Areal Calama J&#44; et al&#46; Embolizaci&#243;n prost&#225;tica como tratamiento para pacientes con hiperplasia benigna de pr&#243;stata portadores de sonda vesical permanente no tributarios a cirug&#237;a desobstructiva&#46; Actas Urol Esp&#46; 2021&#59;45&#58;481&#8211;485&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patients&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&#44; median &#40;interquartile range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;79&#8722;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#91;2&#44;0&#93; Anticoagulant medicines&#44; n &#40;&#37;&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;46&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antiplatelets&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;42&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anticoagulants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Charlson score &#8805; 7&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;88&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prostate volume in mL&#44; median &#40;interquartile range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;72&#8722;112&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PSA &#40;ng&#47;mL&#41;&#44; median &#40;interquartile range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;9 &#40;1&#44;8&#8722;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Length of hospital stay &#8804; 24&#8239;h&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;96&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#91;1&#44;0&#93; Arterial embolization n &#40;&#37;&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;76&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Unilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2685410.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical and demographic characteristics of patients undergoing prostatic arterial embolization&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">According to Clavien-Dindo&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Description&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;76&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urinary retention after bladder catheter removal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infection requiring antibiotic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bladder rupture after manual bladder irrigation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Potentially fatal complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2685409.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Summary of complications after prostatic artery embolization&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#91;0&#44;2&#8211;4&#93; Time after prostatic artery embolization</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">30 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">60 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Successful voiding attempt&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Failed voiding attempt&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cumulative success rate&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2685408.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Spontaneous micturition rate after catheter removal&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:20 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worldwide prevalence estimates of lower urinary tract symptoms&#44; overactive bladder&#44; urinary incontinence&#44; and bladder outlet obstruction&#58; worldwide prevalence of luts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;L&#46; Griebling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1464-410X.2011.10498.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "BJU Int"
                        "fecha" => "2011"
                        "volumen" => "108"
                        "paginaInicial" => "1138"
                        "paginaFinal" => "1139"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21914110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Urgency and other lower urinary tract symptoms in men aged &#8805; 40 years&#58; a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; De Ridder"
                            1 => "T&#46; Roumegu&#232;re"
                            2 => "L&#46; Kaufman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijcp.12541"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Clin Pract"
                        "fecha" => "2015"
                        "volumen" => "69"
                        "paginaInicial" => "358"
                        "paginaFinal" => "365"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25648652"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Urinary catheters&#58; history&#44; current status&#44; adverse events and research agenda"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;C&#46;L&#46; Feneley"
                            1 => "I&#46;B&#46; Hopley"
                            2 => "P&#46;N&#46;T&#46; Wells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/03091902.2015.1085600"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Eng Technol"
                        "fecha" => "2015"
                        "volumen" => "39"
                        "paginaInicial" => "459"
                        "paginaFinal" => "470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26383168"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Strategies for preventing catheter-associated urinary tract infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46; Assadi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/ijpvm.IJPVM_299_17"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Prev Med"
                        "fecha" => "2018"
                        "volumen" => "9"
                        "paginaInicial" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29963301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of patients with long-term indwelling urinary catheters&#58; a review of guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;C&#46; Lachance"
                            1 => "A&#46; Grobelna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2019"
                        "editorial" => "Canadian Agency for Drugs and Technologies in Health"
                        "editorialLocalizacion" => "Ottawa &#40;ON&#41;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EAU guidelines on the management of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Gravas"
                            1 => "J&#46;N&#46; Cornu"
                            2 => "C&#46; Gacci"
                            3 => "C&#46; Gratzke"
                            4 => "T&#46;R&#46; Herrmann"
                            5 => "C&#46; Mamoulakis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2014.12.038"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2020"
                        "volumen" => "67"
                        "paginaInicial" => "1099"
                        "paginaFinal" => "1109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25613154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostataarterienembolisation &#40;PAE&#41;&#58; Technik und Ergebnisse"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Kov&#225;cs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00117-017-0248-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "Radiol"
                        "fecha" => "2017"
                        "volumen" => "57"
                        "paginaInicial" => "641"
                        "paginaFinal" => "651"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostate artery embolization for benign prostatic hyperplasia&#58; current status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Mirakhur"
                            1 => "J&#46;P&#46; McWilliams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.carj.2016.06.003"
                      "Revista" => array:5 [
                        "tituloSerie" => "Can Assoc Radiol J"
                        "fecha" => "2017"
                        "volumen" => "68"
                        "paginaInicial" => "84"
                        "paginaFinal" => "89"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical&#44; laboratorial&#44; and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia&#46; a prospective single-center pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;A&#46; Antunes"
                            1 => "F&#46;C&#46; Carnevale"
                            2 => "J&#46;M&#46; da Motta Leal Filho"
                            3 => "E&#46;M&#46; Yoshinaga"
                            4 => "L&#46;M&#46;O&#46; Cerri"
                            5 => "R&#46;H&#46; Baroni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00270-013-0611-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Intervent Radiol"
                        "fecha" => "2013"
                        "volumen" => "36"
                        "paginaInicial" => "978"
                        "paginaFinal" => "986"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23580116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostatic artery embolization in benign prostatic hyperplasia&#58; preliminary results in 13 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Grosso"
                            1 => "A&#46; Balderi"
                            2 => "M&#46; Arn&#242;"
                            3 => "D&#46; Sortino"
                            4 => "A&#46; Antonietti"
                            5 => "F&#46; Pedrazzini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11547-014-0447-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Radiol Med &#40;Torino&#41;"
                        "fecha" => "2015"
                        "volumen" => "120"
                        "paginaInicial" => "361"
                        "paginaFinal" => "368"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostatic artery embolization as an alternative to indwelling bladder catheterization to manage benign prostatic hyperplasia in poor surgical candidates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Rampoldi"
                            1 => "F&#46; Barbosa"
                            2 => "S&#46; Secco"
                            3 => "C&#46; Migliorisi"
                            4 => "A&#46; Galfano"
                            5 => "G&#46; Prestini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00270-017-1582-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Intervent Radiol"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "530"
                        "paginaFinal" => "536"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28130568"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies&#58; development and validation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;E&#46; Charlson"
                            1 => "P&#46; Pompei"
                            2 => "K&#46;L&#46; Ales"
                            3 => "C&#46;R&#46; MacKenzie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0021-9681(87)90171-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Chronic Dis"
                        "fecha" => "1987"
                        "volumen" => "40"
                        "paginaInicial" => "373"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3558716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of prostatic artery embolization technical outcomes&#58; patient and procedural factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; du Pisanie"
                            1 => "A&#46; Abumoussa"
                            2 => "K&#46; Donovan"
                            3 => "J&#46; Stewart"
                            4 => "S&#46; Bagla"
                            5 => "A&#46; Isaacson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvir.2018.09.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Interv Radiol"
                        "fecha" => "2019"
                        "volumen" => "30"
                        "paginaInicial" => "233"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30717955"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Perera"
                            1 => "M&#46;J&#46; Roberts"
                            2 => "S&#46;A&#46;R&#46; Doi"
                            3 => "D&#46; Bolton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2014.10.031"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2015"
                        "volumen" => "67"
                        "paginaInicial" => "704"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25466940"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "iTIND&#58; the second-generation temporary implantable nitinol device for minimally invasive treatment of benign prostatic hyperplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Balakrishnan"
                            1 => "P&#46; Jones"
                            2 => "B&#46;K&#46; Somani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1756287220934355"
                      "Revista" => array:3 [
                        "tituloSerie" => "Ther Adv Urol"
                        "fecha" => "2020"
                        "volumen" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;C&#46; Carnevale"
                            1 => "J&#46;M&#46; da Motta-Leal-Filho"
                            2 => "A&#46;A&#46; Antunes"
                            3 => "R&#46;H&#46; Baroni"
                            4 => "A&#46;S&#46;Z&#46; Marcelino"
                            5 => "L&#46;M&#46;O&#46; Cerri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvir.2012.12.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Interv Radiol"
                        "fecha" => "2013"
                        "volumen" => "24"
                        "paginaInicial" => "535"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23434084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia&#58; a comparative study of medium- and large-volume prostates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Wang"
                            1 => "L&#46; Guo"
                            2 => "F&#46; Duan"
                            3 => "K&#46; Yuan"
                            4 => "G&#46; Zhang"
                            5 => "K&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bju.13147"
                      "Revista" => array:6 [
                        "tituloSerie" => "BJU Int"
                        "fecha" => "2016"
                        "volumen" => "117"
                        "paginaInicial" => "155"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25851432"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review of adverse events related to prostatic artery embolization for treatment of bladder outlet obstruction due to BPH"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Moreira"
                            1 => "A&#46;M&#46; de Assis"
                            2 => "F&#46;C&#46; Carnevale"
                            3 => "A&#46;A&#46; Antunes"
                            4 => "M&#46; Srougi"
                            5 => "G&#46;G&#46; Cerri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00270-017-1765-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Intervent Radiol"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "1490"
                        "paginaFinal" => "1500"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28795212"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transient ischemic rectitis as a potential complication after prostatic artery embolization&#58; case report and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Moreira"
                            1 => "C&#46;F&#46;S&#46; Marques"
                            2 => "A&#46;A&#46; Antunes"
                            3 => "C&#46;S&#46;R&#46; Nahas"
                            4 => "C&#46;S&#46;R&#46; Nahas"
                            5 => "M&#46;&#193; de Gregorio Ariza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00270-013-0739-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Intervent Radiol"
                        "fecha" => "2013"
                        "volumen" => "36"
                        "paginaInicial" => "1690"
                        "paginaFinal" => "1694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24091752"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An&#225;lisis de las complicaciones en el aprendizaje del HoLEP&#58; revisi&#243;n sistem&#225;tica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Agreda Casta&#241;eda"
                            1 => "&#211;&#46; Buisan Rueda"
                            2 => "J&#46;J&#46; Areal Calama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.acuro.2019.08.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Urol Esp"
                        "fecha" => "2020"
                        "volumen" => "44"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31822354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735786/0000004500000007/v1_202109020840/S2173578621000834/v1_202109020840/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6274"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004500000007/v1_202109020840/S2173578621000834/v1_202109020840/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578621000834?idApp=UINPBA00004N"
]
Article information
ISSN: 21735786
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2023 March 1 0 1
2022 March 1 0 1

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos