6Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
EFFICIENCY OF PROSTATIC ARTERY EMBOLIZATION IN TREATMENT OF BENIGN PROSTATE HYPERTENSION
Jamshid Rajabboevich Nazarov Shavkat Maksudovich Khamroev Bobur Bokodirovich Safoev
Bukhara State Medical Institute
ABSTRACT
One of the most common urological diseases in older men is benign prostatic hyperplasia. The prevalence of this disease increases significantly with age, so the incidence of BPH is 60% by the age of 60, and up to 80% by the age of 80. The aim of the study was to evaluate the efficacy and safety of EPA in the treatment of benign prostatic hyperplasia. Research results have shown that embolization of prostatic arteries is an effective minimally invasive method of treating benign prostatic hyperplasia.
Keywords: prostate gland, benign hyperplasia, prostatic artery embolization.
INTRODUCTION
Benign prostatic hyperplasia (BPH) is the proliferation of smooth muscle fibers and epithelial cells in the transient zone of the prostate gland. The prevalence of moderate to severe BPH is about 50% of men in their 60s and almost 90% in men 85. According to various studies, 90% of men aged 45 to 80 years to some extent suffer from symptoms of the lower urinary tract (LUTS) [1]. BPH can lead to complications such as acute urinary retention, renal failure, massive hematuria, bladder stones, urinary incontinence, and recurrent urinary tract infection (UTI) [4].
Modern medicine is able to offer the patient a variety of fairly effective treatment methods, the main of which remains conservative therapy. However, in cases where drug treatment is ineffective, the patient is shown to perform surgical treatment [7].
Today, the leading place in the surgical treatment of BPH is occupied by endoscopic surgery. Transurethral resection of the prostate (TURP) is the gold standard for surgical treatment of BPH. Nevertheless, despite many years of experience in performing, TURP can cause complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck
Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
sclerosis, etc., and cannot be performed in a patient with a high surgical and anesthetic risk. Both modern methods of laser transurethral surgery and other surgical techniques for treating BPH, such as retropubic and laparoscopic adenomectomy, have similar limitations. Often, it is impossible to perform a surgical aid to a patient due to a burdened somatic status; therefore, minimally invasive surgical methods for treating BPH, which reduce the amount of anesthetic aid, the duration of surgical treatment, and reduce postoperative complications, are of particular importance [3,4]. Minimally invasive surgical methods for the treatment of BPH, such as transurethral incision of the prostate, transurethral microwave therapy (TUMT), transurethral electrovaporization of the prostate (TUVP), transurethral needle ablation of the prostate, etc., are usually performed under general anesthesia and cannot always be performed on the patient. with severe concomitant diseases. Among the many minimally invasive surgical methods for treating BPH, attention is drawn to superselective embolization of the arteries of the prostate (embolization of the prostatic arteries; EPA), the main advantage of which is that it is performed under local anesthesia and can be used in the treatment of elderly patients with severe concomitant pathology [ 5.7].
In the context of an increase in life expectancy and an increase in the structure of BPH morbidity in elderly patients with aggravated somatic status, minimally invasive methods of surgical treatment are of particular importance.
Embolization of the arteries of the prostate is one of the most promising methods of minimally invasive treatment of BPH.
The aim of the study was to evaluate the efficacy and safety of EPA in the treatment of BPH.
METODOLOGY
The results of treatment of 53 patients who underwent EPA for BPH were analyzed. The average age of the patients was 73 years (range 62 to 83 years). The average volume of the prostate gland is 86 cm3 (from 67 to 105 cm3). Six patients had previously undergone trocar cystectomy for acute urinary retention. The effectiveness of treatment was assessed by the dynamics of the following indicators:
restoration of independent urination;
• IPSS (International Prostatic Symptom Scale);
• Qmax (uroflowmetry);
• the volume of the prostate and residual urine (ultrasound).
Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
Safety was assessed by the incidence and severity of postoperative complications.
RESULTS AND DISCUSSION
All patients noted positive dynamics in assessing the quality of urination. The epicystostomy drain was removed in all patients who had previously undergone trocarcystostomy within 3 days after EPA. In 5 (9%) patients, the EPA effect was
insufficient (spontaneous urination was restored, however, a large amount of residual urine remained), and therefore required a subsequent TUR of the prostate gland. 4 (8%) patients developed ischemia of the glans penis with superficial tissue necrosis. Against the background of conservative therapy, the complication was completely resolved. Prostatic symptoms according to the International Scale decreased after EPA from 25.3 to 10. The Qmax value increased from 8 to 15 ml / s. The mean prostate volume decreased from 86 to 56 cm3. The most pronounced effect was observed in relation to the residual urine volume.
4 (8%) patients developed ischemia of the glans penis with superficial tissue necrosis. Against the background of conservative therapy, the complication was completely resolved. Prostatic symptoms according to the International Scale decreased after EPA from 25.3 to 10. The Qmax value increased from 8 to 15 ml / s. The mean prostate volume decreased from 86 to 56 cm3. The most pronounced effect was observed in relation to the residual urine volume. These techniques are advisable for wider application when inter current diseases do not allow performing radical surgery for BPH. and to assess the patient's surgical and anesthetic risk. Based on the data available to date, super selective embolization of the arteries of the prostate is an effective and safe minimally invasive method of treating BPH for elderly patients with aggravated somatic status and the method of choice for patients at high anesthetic risk. Performing super selective prostatic artery embolization requires a high level of surgical skill and knowledge of pelvic x-ray anatomy. International observation data and our own experience indicate that embolization of the arteries of the prostate is the most effective technique for endovascular X-ray treatment of BPH.
CONCLUSION
An urgent scientific task is the accumulation of experience in the implementation of this type of treatment, the study of the structure and causes of
Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
complications and the further development of methods for their prevention and treatment.
One of the main tasks for the further development of EPA is to resolve the issue of the optimal selection of an embolization drug.
We consider it possible to expand the indications for performing super selective embolization of prostatic arteries, as well as wider application of this technique in clinical practice.
REFERENCES
1. Carnevale F. C., Motta Leal Filho J. M., Antunes A. A. et al. Quality of life and symptoms relief support prostatic artery embolization for patients with acute urinary retention due to benign prostatic hyperplasia. J VascIntervRadiol 2012; 24 (4): 535P42.
2. Pisco J. M., Pinheiro L. C., Bilhim T. et al. Prostatic arterial embolization to treat benign prostatic hyperplasia. J VascIntervRadiol 2011; 22 (1): 11P9.
3. Carnevale F. C., Antunes A. A., da Motta Leal Filho J. M. et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol 2010 33 (2): 355P61.
4. Notov KG, Kim GV, Dobryak A. Yu. Et al. Results of embolization of the arteries of the prostate R method of surgical treatment of benign prostatic hyperplasia. Medicine and education in Siberia 2015; 5. http://www.ngmu.ru/cozo/mos/article/text_full. php? id = 1126. [Notov K. G., Kim G. V., Dobryak A. Yu. et al. Results of prostatic artery embolization, a method for surgical treatment of benign prostatic hyperplasia. Meditsina i obrazovanie v Sibiri Medicine and Education in Siberia 2015; 5. (InRuss.)].
5. Yakovets EA, Neimark AI, Karpenko AA, Yakovets Ya. V. Embolization of prostate arteries in the treatment of patients with prostate adenoma with high surgical risk. Andrology and Genital Surgery 2010; (1): 38P43. [Yakovets E. A., Neymark A. I., Karpenko A. A., Yakovets Ya. V. Prostatic artery embolization in treatment of patients with prostate adenoma and high surgical risk. Andrologiya i genitalnaya khirurgiya = Andrology and Genital Surgery 2010; 1: 38P43. (In Russ.)].
6. Neimark AI, Tachalov MA, Neimark BA et al. The use of superselective X-ray endovascular chemo-embolization in the treatment of patients with localized prostate cancer: our first experience. Experimental Clinical Urology 2016; (3): 42P47. [Neymark A. I., Tachalov B. A., Neymark D. D. Application of the superselective
Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
roentgen-endovascular chemoembolization in the treatment of patients with localized prostate cancer: our first experience. Experimentalnaya i clinicheskaya urologiya = Experimental and Clinical Urology 2016; 3: 42Р47 (In Russ.)].
7. Zhukov OB, Ukolov VA, Shcherbinin SN, Snitkin VM Protocol for the management of patients with X-ray endovascular embolization of the arteries of the prostate in its benign hyperplasia. Andrology and Genital Surgery 2016; 17 (2): 68P76. [Zhukov O. B., Ukolov V. A., Shcherbinin S. N., Snitkin V. M. Algorithm for management of patients with X-ray endovascular artery embolization of the prostate for its benign hyperplasia. Andrologiya i genitalnaya khirurgiya ,Andrology and Genital Surgery 2016; 17 (2): 68Р76. (In Russ.)].
8.H., Davlatova M. "Aspectual Variability of Information Culture in the History of the English Language." International Journal on Integrated Education, vol. 3, no. 3, 2020, pp. 24-28, doi: 10.31149/ijie.v3i3.81.
9. Davlatova, M. H. "Variability of A spectual Meanings in English." European Journal of Research and Reflection in Educational Science 7.12.2019 (2019): 778780.
10. Davlatova, M. H. "An Integrative history of Aspectual meanings." JournalNX-A Multidisciplinary Peer Reviewed Journal, Volume6 4 (2020): 17-22.
11. Давлатова, Мухайё Хасановна. "The role of songs in learning English." Молодой ученый 10 (2015): 1145-1147.
12.. Mukhayyo Hasanovna Davlatova, "RELATION OF LEXICAL-SEMANTIC STRUCTURE OF VERBS IN THE LINGUISTIC ESSENCE", IEJRD -International Multidisciplinary Journal, vol. 6, no. SP, p. 5, Jan. 2021.
13. Davlatova, Mukhayyo H. "Lexico-semantic Structure and Its Analysis on the Example of Verbs." JournalNX,, vol. 6, no. 06, 2020, pp. 189-192.
14. Давлатова, Мухайё Хасановна. "Этапы работы с видеотекстами на занятиях Английского языка." Интернаука 9-2 (2017): 16-19.
15. Davlatova Mukhayyo Hasanovna. (2021). DIFFERENT ASPECTS OF RESULTATIVE STRUCTURES ACCORDING TO THEIR LINGUISTIC ESSENCE. Academicia Globe: Inderscience Research, 2(05), 475-479. https://doi.org/10.17605/OSF.IO/D4T8J.
16. Hasanovna, Davlatova Mukhayyo. "SEMANTIC IMPLEMENTATION OF RESULTUTIVE STRUCTURES." METHODS 7.6 (2021).
Academic Research in Educational Sciences VOLUME 2 | ISSUE 10 | 2021
ISSN: 2181-1385
Scientific Journal Impact Factor (SJIF) 2021: 5.723 Directory Indexing of International Research Journals-CiteFactor 2020-21: 0.89
DOI: 10.24412/2181-1385-2021-10-456-461
17.Hasanovna, Davlatova Muhayyo. "VARIABILITY OF ASPECTUAL MEANINGS IN ENGLISH." European Journal of Research and Reflection in Educational Sciences Vol 7.12 (2019).
18.NA Narzieva, N Hasanova. Communicative competence as a pedagogical model in the classrooms// ACADEMICIA: An international Multidisciplinary Research Journal 10(6),78-81, 2020
19. NA Narzieva. The concept of defined target technologies and their role in the educational process// Theoretical &Applied science, 356-360, 2020
20. AD Ahmedovna, Narziyeva N.A, Main styles and methods of teaching speaking foreign languages to medical institutes , International Engineering Journal for research and development 6 (SP), 4-4, 2021
21. NN Narzieva, Development of Education and Research Activity Profile Class Students on the Basis of Integrative and Personal Approach, www. auris-verlag, 2017
22. NN Narzieva Development of Education and Research Activity Profile Class Students on the Basis of Integrative and Personal Approach, www.auris-verlag. de, 2017
23. NN Atakulovna Factors supporting teaching and learning English in non-English speaking countries, ResearchJet Journal of Analysis and inventions 2(06), 297-305, 2021.
24.Qurbanov О.M., Boltaev T.Sh, Sharopova M.S. Recovery of purulent injuries on the background of a diffuse toxic goiter in combination with diabetes mellitus// International engineering journal for research and development Vol.5Issue 9 2020.p 1-10.
