Management of refractory haematuria following radiation therapy and recurrent adenocarcinoma of the prostate with fluoroscopic-guided selective pelvic embolization

Haematuria is a known complication of prostatic malignancy and in severe cases can be unresponsive to bladder irrigation and endoscopic interventions. This report describes selective angiographic embolization as a means of haemorrhage control in adenocarcinoma of the prostate. A patient with locally advanced prostatic adenocarcinoma and prior history of prostate brachytherapy, androgen deprivation therapy and chemotherapy presented with persistent haematuria that did not respond to endourological intervention. He was successfully treated with selective embolization of the vesical and prostatic vessels under fluoroscopic guidance. Angiographic embolization represents a safe and effective means of achieving haemostasis in patients not fit for surgerywho would otherwise be resigned to terminal care treatment.