Endovascular Interventional Radiology of the Urogenital Tract

Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.

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Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis

International Journal of Urology ◽

10.1111/iju.12857 ◽

2015 ◽

Vol 22 (10) ◽

pp. 962-966 ◽

Cited By ~ 16

Author(s):

Tiago M Ribeiro de Oliveira ◽

António J Carmelo Romão ◽

Francisco M Gamito Guerreiro ◽

Tomé M Matos Lopes

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Hemorrhagic Cystitis ◽

Radiation Induced

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The Use of Multiple Foley Balloon Catheters for Treating Life-Threatening Radiation Induced Hemorrhagic Cystitis

Journal of Clinical Case Reports ◽

10.4172/2165-7920.1000899 ◽

2016 ◽

Vol 6 (12) ◽

Author(s):

Wen Ming Chen ◽

Hsien Chih Lin ◽

Chuo Jung Tsai

Keyword(s):

Hemorrhagic Cystitis ◽

Balloon Catheters ◽

Life Threatening ◽

Radiation Induced

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Laparoscopic Cystoprostatectomy for Radiation-Induced Hemorrhagic Cystitis

Journal of Endourology ◽

10.1089/end.2008.0432 ◽

2009 ◽

Vol 23 (2) ◽

pp. 275-278 ◽

Cited By ~ 18

Author(s):

Amr F. Fergany ◽

Ayman S. Moussa ◽

Inderbir S. Gill

Keyword(s):

Hemorrhagic Cystitis ◽

Radiation Induced

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Radiation Safety in Vascular Surgery

10.2310/vasc.3007 ◽

2015 ◽

Author(s):

Amy B. Reed ◽

Melissa L Kirkwood

Keyword(s):

Radiation Dose ◽

Endovascular Procedures ◽

Radiation Safety ◽

National Council ◽

Skin Injury ◽

Air Kerma ◽

Dose Limits ◽

Radiation Induced ◽

Effects Of Radiation ◽

Harmful Effects

Modern vascular surgeons perform an ever-increasing number of complex endovascular procedures, largely based on patient preference, decreased length of stay, and improved outcome. With the upsurge of endovascular cases, concern has grown regarding the harmful effects of radiation exposure delivered to the patient and the operator. Surgeon education on the appropriate use of fluoroscopic operating factors coupled with appropriate training in radiation safety has been shown to decrease radiation dose. This review elucidates dose terminology and metrics, possible radiation-induced injuries, risk factors for deterministic injury, and radiation safety principles and techniques. Tables provide practical tips to lower patient and operator radiation dose during fluoroscopically guided intervention, and National Council on Radiation Protection & Measurements recommended dose limits for occupational exposure. Figures illustrate reference air kerma, radiation-induced skin injury, effects of image receptor and table position, and operator exposure. This review contains 4 figures, 3 tables, and 53 references.

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A CASE OF PREDNISOLONE THERAPY FOR RADIATION-INDUCED HEMORRHAGIC CYSTITIS

The Japanese Journal of Urology ◽

10.5980/jpnjurol.102.600 ◽

2011 ◽

Vol 102 (3) ◽

pp. 600-602 ◽

Cited By ~ 1

Author(s):

Masato Yanagi ◽

Taiji Nishimura ◽

Susumu Kurita ◽

Chorsu Lee ◽

Yukihiro Kondo ◽

...

Keyword(s):

Hemorrhagic Cystitis ◽

Prednisolone Therapy ◽

Radiation Induced

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Evaluation of stereotactic radiosurgery for cerebral dural arteriovenous fistulas in a multicenter international consortium

Journal of Neurosurgery ◽

10.3171/2018.8.jns181467 ◽

2020 ◽

Vol 132 (1) ◽

pp. 114-121 ◽

Cited By ~ 2

Author(s):

Robert M. Starke ◽

David J. McCarthy ◽

Ching-Jen Chen ◽

Hideyuki Kano ◽

Brendan McShane ◽

...

Keyword(s):

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Multivariate Logistic Regression Analysis ◽

Favorable Outcome ◽

Predictors Of Outcome ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Radiation Induced ◽

Venous Ectasia ◽

Grading Scales

OBJECTIVEIn this multicenter study, the authors reviewed the results obtained in patients who underwent Gamma Knife radiosurgery (GKRS) for dural arteriovenous fistulas (dAVFs) and determined predictors of outcome.METHODSData from a cohort of 114 patients who underwent GKRS for cerebral dAVFs were compiled from the International Gamma Knife Research Foundation. Favorable outcome was defined as dAVF obliteration and no posttreatment hemorrhage or permanent symptomatic radiation-induced complications. Patient and dAVF characteristics were assessed to determine predictors of outcome in a multivariate logistic regression analysis; dAVF-free obliteration was calculated in a competing-risk survival analysis; and Youden indices were used to determine optimal radiosurgical dose.RESULTSA mean margin dose of 21.8 Gy was delivered. The mean follow-up duration was 4 years (range 0.5–18 years). The overall obliteration rate was 68.4%. The postradiosurgery actuarial rates of obliteration at 3, 5, 7, and 10 years were 41.3%, 61.1%, 70.1%, and 82.0%, respectively. Post-GRKS hemorrhage occurred in 4 patients (annual risk of 0.9%). Radiation-induced imaging changes occurred in 10.4% of patients; 5.2% were symptomatic, and 3.5% had permanent deficits. Favorable outcome was achieved in 63.2% of patients. Patients with middle fossa and tentorial dAVFs (OR 2.4, p = 0.048) and those receiving a margin dose greater than 23 Gy (OR 2.6, p = 0.030) were less likely to achieve a favorable outcome. Commonly used grading scales (e.g., Borden and Cognard) were not predictive of outcome. Female sex (OR 1.7, p = 0.03), absent venous ectasia (OR 3.4, p < 0.001), and cavernous carotid location (OR 2.1, p = 0.019) were predictors of GKRS-induced dAVF obliteration.CONCLUSIONSGKRS for cerebral dAVFs achieved obliteration and avoided permanent complications in the majority of patients. Those with cavernous carotid location and no venous ectasia were more likely to have fistula obliteration following radiosurgery. Commonly used grading scales were not reliable predictors of outcome following radiosurgery.

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Early hyperbaric oxygen therapy improves radiation induced hemorrhagic cystitis and proctitis

European Urology Supplements ◽

10.1016/s1569-9056(19)34660-3 ◽

2019 ◽

Vol 18 (11) ◽

pp. e3507

Author(s):

H. Takeda ◽

G. Kimura ◽

J. Akatsuka ◽

Y. Endo ◽

T. Hayashi ◽

...

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Hemorrhagic Cystitis ◽

Radiation Induced

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Radiation-Induced Alopecia after Endovascular Embolization under Fluoroscopy

Case Reports in Dermatological Medicine ◽

10.1155/2016/8202469 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Vipawee Ounsakul ◽

Wimolsiri Iamsumang ◽

Poonkiat Suchonwanit

Keyword(s):

Cerebral Angiography ◽

Endovascular Procedures ◽

Endovascular Embolization ◽

Target Pattern ◽

Geometric Shapes ◽

Radiation Induced

Radiation-induced alopecia after fluoroscopically guided procedures is becoming more common due to an increasing use of endovascular procedures. It is characterized by geometric shapes of nonscarring alopecia related to the area of radiation. We report a case of a 46-year-old man presenting with asymptomatic, sharply demarcated rectangular, nonscarring alopecic patch on the occipital scalp following cerebral angiography with fistula embolization under fluoroscopy. His presentations were compatible with radiation-induced alopecia. Herein, we also report a novel scalp dermoscopic finding of blue-grey dots in a target pattern around yellow dots and follicles, which we detected in the lesion of radiation-induced alopecia.

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