{"id":1404,"date":"2019-11-03T15:34:51","date_gmt":"2019-11-03T15:34:51","guid":{"rendered":"https:\/\/adenome-prostate.com\/?p=1404"},"modified":"2026-09-23T14:40:20","modified_gmt":"2026-09-23T14:40:20","slug":"nhs-recommends-embolization","status":"publish","type":"post","link":"https:\/\/adenome-prostate.com\/en\/nhs-recommande-lembolisation\/","title":{"rendered":"NHS recommends prostate artery embolization"},"content":{"rendered":"\n[et_pb_section fb_built=\u00a0\u00bb1&Prime; custom_padding_last_edited=\u00a0\u00bbon|desktop\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb background_color=\u00a0\u00bb#E6EDEB\u00a0\u00bb background_enable_color=\u00a0\u00bbon\u00a0\u00bb custom_padding=\u00a0\u00bb|15px||15px|false|true\u00a0\u00bb custom_padding_tablet=\u00a0\u00bb|50px||50px|false|true\u00a0\u00bb custom_padding_phone=\u00a0\u00bb|10px||10px|false|true\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_row _builder_version=\u00a0\u00bb4.27.2&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb width=\u00a0\u00bb100%\u00a0\u00bb width_tablet=\u00a0\u00bb100%\u00a0\u00bb width_phone=\u00a0\u00bb89%\u00a0\u00bb width_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb max_width=\u00a0\u00bb100%\u00a0\u00bb module_alignment=\u00a0\u00bbcenter\u00a0\u00bb custom_padding=\u00a0\u00bb41px|||||\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4&Prime; _builder_version=\u00a0\u00bb4.19.0&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb|14px||0px|false|false\u00a0\u00bb border_color_right=\u00a0\u00bb#cccccc\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text _builder_version=\u00a0\u00bb4.27.9&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb text_text_color=\u00a0\u00bb#000000&Prime; text_font_size=\u00a0\u00bb15px\u00a0\u00bb header_font=\u00a0\u00bb|600|||||||\u00a0\u00bb header_font_size=\u00a0\u00bb47px\u00a0\u00bb header_2_font=\u00a0\u00bb|600|||||||\u00a0\u00bb header_2_text_color=\u00a0\u00bbRGBA(0,11,48,0.82)\u00a0\u00bb header_2_font_size=\u00a0\u00bb28px\u00a0\u00bb width=\u00a0\u00bb98%\u00a0\u00bb max_width=\u00a0\u00bb100%\u00a0\u00bb custom_margin=\u00a0\u00bb|0px||0px|false|false\u00a0\u00bb custom_margin_tablet=\u00a0\u00bb|0px||0px|false|false\u00a0\u00bb custom_margin_phone=\u00a0\u00bb|48px||48px|false|false\u00a0\u00bb custom_margin_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; border_color_right=\u00a0\u00bbRGBA(0,11,48,0.82)\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb sticky_enabled=\u00a0\u00bb0&Prime;]<h3>Une prostate \u00e9largie<\/h3>\n<p>Plus du tiers des hommes de plus de 50 ans ont une hypertrophie de la prostate, ce qui peut les rendre plus difficiles \u00e0 uriner.<br>Des m\u00e9dicaments ou une op\u00e9ration peuvent aider, mais l\u2019Institut national pour l\u2019excellence de la sant\u00e9 et des soins estime qu\u2019il faudrait d\u00e9sormais offrir aux hommes une autre option de traitement.<br>L&rsquo;EAP (embolisation de l&rsquo;art\u00e8re prostatique) &nbsp;peut \u00eatre pratiqu\u00e9 sous anesth\u00e9sie locale, ce qui signifie que les patients peuvent rentrer chez eux peu de temps apr\u00e8s sans devoir \u00eatre hospitalis\u00e9s, contrairement \u00e0 la chirurgie classique de la prostate.<br>Les m\u00e9decins passent un petit tube dans une art\u00e8re de l&rsquo;aine qui peut \u00eatre guid\u00e9e dans les petits vaisseaux sanguins de la prostate.<span style=\"font-size: 14px;\">&nbsp;<\/span><\/p>\n<p><span style=\"font-size: 14px;\"><\/span><\/p>\n<h3>Le traitement de la prostate au Royaume-Uni<\/h3>\n<p>&nbsp;<\/p>\n<p>Au Royaume-Uni, environ 20 centres proposent d\u00e9j\u00e0 le traitement de la prostate par embolisation.<br>Le Dr Nigel Hacking, radiologue interventionnel et consultant \u00e0 l\u2019H\u00f4pital universitaire de Southampton, a d\u00e9clar\u00e9: <span style=\"text-decoration: underline;\">\u00ab\u00a0C\u2019est une option particuli\u00e8rement int\u00e9ressante pour les hommes qui ne sont pas encore pr\u00eats \u00e0 subir une chirurgie de la prostate plus invasive. Le maintien de la fonction sexuelle et de la fertilit\u00e9 est l\u2019un de ses principaux atouts.\u00a0\u00bb<\/span><\/p>\n<h2><span>Pourquoi le Royaume-Uni s\u2019est-il int\u00e9ress\u00e9 \u00e0 l\u2019embolisation prostatique ?<\/span><\/h2>\n<p class=\"isSelectedEnd\"><span>L\u2019hypertrophie b\u00e9nigne de la prostate est particuli\u00e8rement fr\u00e9quente avec l\u2019\u00e2ge.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Lorsque la prostate augmente de volume, elle peut comprimer l\u2019ur\u00e8tre et provoquer diff\u00e9rents troubles urinaires :<\/span><\/p>\n<ul data-spread=\"false\">\n<li><span>un <\/span><strong><span>jet urinaire plus faible<\/span><\/strong><span> ;<\/span><\/li>\n<li><span>des difficult\u00e9s \u00e0 commencer \u00e0 uriner ;<\/span><\/li>\n<li><span>des envies fr\u00e9quentes d\u2019uriner ;<\/span><\/li>\n<li><span>des r\u00e9veils nocturnes ;<\/span><\/li>\n<li><span>une sensation de mauvaise vidange de la vessie ;<\/span><\/li>\n<li><span>parfois une r\u00e9tention urinaire.<\/span><\/li>\n<\/ul>\n<p class=\"isSelectedEnd\"><span>Lorsque les m\u00e9dicaments ne sont plus suffisamment efficaces ou sont mal tol\u00e9r\u00e9s, une intervention peut \u00eatre envisag\u00e9e.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Pendant longtemps, les principales solutions reposaient sur des traitements chirurgicaux ou endoscopiques, notamment la r\u00e9section transur\u00e9trale de la prostate (RTUP).<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>L\u2019embolisation offre une approche diff\u00e9rente : traiter la prostate <\/span><strong><span>par les art\u00e8res<\/span><\/strong><span>, sans introduire d\u2019instrument chirurgical dans l\u2019ur\u00e8tre.<\/span><\/p>\n<h3><span>Que dit r\u00e9ellement le NICE sur l\u2019embolisation ?<\/span><\/h3>\n<p class=\"isSelectedEnd\"><span>Le NICE est l\u2019organisme britannique charg\u00e9 d\u2019\u00e9valuer notamment l\u2019efficacit\u00e9 et la s\u00e9curit\u00e9 de nombreux traitements utilis\u00e9s dans le syst\u00e8me de sant\u00e9.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Ses recommandations concernant l\u2019embolisation des art\u00e8res prostatiques indiquent que les preuves concernant la s\u00e9curit\u00e9 et l\u2019efficacit\u00e9 de la proc\u00e9dure sont suffisantes pour permettre son utilisation dans le cadre habituel des soins, \u00e0 condition que les r\u00e8gles de consentement, de gouvernance clinique et de suivi soient respect\u00e9es.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Cette position est importante car elle montre que l\u2019embolisation n\u2019est plus consid\u00e9r\u00e9e comme une technique purement exp\u00e9rimentale.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Plusieurs \u00e9tablissements du NHS proposent aujourd\u2019hui cette proc\u00e9dure aux patients pr\u00e9sentant une prostate augment\u00e9e de volume. Des h\u00f4pitaux britanniques tels que Royal Free London ou University College London Hospitals la pr\u00e9sentent comme une <\/span><strong><span>alternative mini-invasive \u00e0 certaines interventions chirurgicales de la prostate<\/span><\/strong><span>.<\/span><\/p>\n<h3><span>Une intervention sans chirurgie de la prostate<\/span><\/h3>\n<p class=\"isSelectedEnd\"><span>L\u2019une des particularit\u00e9s de l\u2019embolisation est qu\u2019elle <\/span><strong><span>ne n\u00e9cessite pas d\u2019incision de la prostate<\/span><\/strong><span>.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Elle ne comporte pas non plus de r\u00e9section du tissu prostatique \u00e0 travers l\u2019ur\u00e8tre.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Dans plusieurs \u00e9tablissements du NHS, la proc\u00e9dure est d\u00e9crite comme un traitement non chirurgical pouvant \u00eatre r\u00e9alis\u00e9 en ambulatoire ou avec une hospitalisation courte.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>L\u2019intervention est g\u00e9n\u00e9ralement r\u00e9alis\u00e9e sous anesth\u00e9sie locale.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>La r\u00e9cup\u00e9ration est donc souvent plus rapide qu\u2019apr\u00e8s certaines interventions chirurgicales traditionnelles.<\/span><\/p>\n<h3><span>Quels sont les avantages recherch\u00e9s ?<\/span><\/h3>\n<p class=\"isSelectedEnd\"><span>Pour certains patients, l\u2019embolisation pr\u00e9sente plusieurs caract\u00e9ristiques int\u00e9ressantes :<\/span><\/p>\n<ul data-spread=\"false\">\n<li><strong><span>absence d\u2019incision chirurgicale<\/span><\/strong><span> de la prostate ;<\/span><\/li>\n<li><span>traitement par voie art\u00e9rielle ;<\/span><\/li>\n<li><span>anesth\u00e9sie g\u00e9n\u00e9ralement locale ;<\/span><\/li>\n<li><span>hospitalisation souvent courte ;<\/span><\/li>\n<li><span>r\u00e9cup\u00e9ration relativement rapide ;<\/span><\/li>\n<li><span>risque limit\u00e9 de certains effets ind\u00e9sirables sexuels ;<\/span><\/li>\n<li><span>possibilit\u00e9 de traiter certaines prostates tr\u00e8s volumineuses.<\/span><\/li>\n<\/ul>\n<p class=\"isSelectedEnd\"><span>Les documents d\u2019information de plusieurs \u00e9tablissements britanniques soulignent notamment le profil favorable de l\u2019embolisation concernant l\u2019\u00e9jaculation, l\u2019incontinence et la fonction sexuelle par rapport \u00e0 certaines techniques chirurgicales.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Cela ne signifie cependant pas que le risque est nul ni que l\u2019embolisation est pr\u00e9f\u00e9rable dans toutes les situations.<\/span><\/p>\n<p>&nbsp;<\/p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00a0\u00bb1&Prime; custom_padding_last_edited=\u00a0\u00bbon|desktop\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb background_color=\u00a0\u00bb#000C11&Prime; background_enable_color=\u00a0\u00bbon\u00a0\u00bb custom_padding=\u00a0\u00bb|15px||15px|false|true\u00a0\u00bb custom_padding_tablet=\u00a0\u00bb|50px||50px|false|true\u00a0\u00bb custom_padding_phone=\u00a0\u00bb|10px||10px|false|true\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_row _builder_version=\u00a0\u00bb4.27.2&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb width=\u00a0\u00bb100%\u00a0\u00bb width_tablet=\u00a0\u00bb100%\u00a0\u00bb width_phone=\u00a0\u00bb89%\u00a0\u00bb width_last_edited=\u00a0\u00bbon|tablet\u00a0\u00bb max_width=\u00a0\u00bb100%\u00a0\u00bb module_alignment=\u00a0\u00bbcenter\u00a0\u00bb custom_padding=\u00a0\u00bb41px|||||\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4&Prime; _builder_version=\u00a0\u00bb4.19.0&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb|14px||0px|false|false\u00a0\u00bb border_color_right=\u00a0\u00bb#cccccc\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text _builder_version=\u00a0\u00bb4.27.9&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb text_font=\u00a0\u00bb&#8211;et_global_body_font||||||||\u00a0\u00bb text_text_color=\u00a0\u00bb#ffffff\u00a0\u00bb text_font_size=\u00a0\u00bb15px\u00a0\u00bb header_font=\u00a0\u00bbEpilogue||||||||\u00a0\u00bb header_text_color=\u00a0\u00bb#000C11&Prime; header_2_font=\u00a0\u00bbEpilogue|600|||||||\u00a0\u00bb header_2_text_color=\u00a0\u00bb#E6EDEB\u00a0\u00bb header_3_font=\u00a0\u00bbEpilogue|600|||||||\u00a0\u00bb header_3_text_color=\u00a0\u00bb#00FFCC\u00a0\u00bb header_4_font=\u00a0\u00bbEpilogue||||||||\u00a0\u00bb header_4_text_color=\u00a0\u00bb#00FFCC\u00a0\u00bb custom_padding=\u00a0\u00bb|0px||0px|false|true\u00a0\u00bb border_width_right=\u00a0\u00bb1px\u00a0\u00bb border_color_right=\u00a0\u00bbRGBA(0,11,48,0.82)\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<h2><span>\u00c0 quels patients l\u2019embolisation peut-elle \u00eatre propos\u00e9e ?<\/span><\/h2>\n<p class=\"isSelectedEnd\"><span>L\u2019embolisation peut \u00eatre envisag\u00e9e chez certains hommes pr\u00e9sentant une <\/span><strong><span>hypertrophie b\u00e9nigne de la prostate symptomatique<\/span><\/strong><span>, en particulier lorsque les m\u00e9dicaments ne permettent plus de contr\u00f4ler suffisamment les sympt\u00f4mes.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Elle peut \u00e9galement \u00eatre int\u00e9ressante pour certains patients :<\/span><\/p>\n<ul data-spread=\"false\">\n<li><span>pr\u00e9sentant une prostate volumineuse ;<\/span><\/li>\n<li><span>souhaitant \u00e9viter une intervention transur\u00e9trale ;<\/span><\/li>\n<li><span>pr\u00e9occup\u00e9s par certains effets secondaires sexuels ;<\/span><\/li>\n<li><span>pr\u00e9sentant des sympt\u00f4mes urinaires importants malgr\u00e9 un traitement m\u00e9dical.<\/span><\/li>\n<\/ul>\n<p class=\"isSelectedEnd\"><span>La d\u00e9cision doit cependant \u00eatre prise apr\u00e8s un bilan complet.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>L\u2019\u00e9valuation tient notamment compte du volume prostatique, de l\u2019anatomie art\u00e9rielle, des sympt\u00f4mes, du d\u00e9bit urinaire et de l\u2019\u00e9tat de la vessie.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Certains patients ne sont pas de bons candidats \u00e0 l\u2019embolisation, notamment en pr\u00e9sence de certaines anomalies vasculaires ou pathologies associ\u00e9es.<\/span><\/p>\n<h3><span>Embolisation ou chirurgie : deux approches diff\u00e9rentes<\/span><\/h3>\n<p class=\"isSelectedEnd\"><span>L\u2019embolisation ne remplace pas syst\u00e9matiquement la chirurgie de la prostate.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Les techniques endoscopiques comme la RTUP ou l\u2019HoLEP restent particuli\u00e8rement efficaces et peuvent \u00eatre pr\u00e9f\u00e9rables dans certaines situations.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>L\u2019embolisation se distingue surtout par son caract\u00e8re <\/span><strong><span>mini-invasif<\/span><\/strong><span> et par l\u2019absence de traitement direct \u00e0 travers l\u2019ur\u00e8tre.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Le choix d\u00e9pend donc de plusieurs crit\u00e8res :<\/span><\/p>\n<ul data-spread=\"false\">\n<li><span>le volume de la prostate ;<\/span><\/li>\n<li><span>l\u2019importance de l\u2019obstruction ;<\/span><\/li>\n<li><span>les sympt\u00f4mes urinaires ;<\/span><\/li>\n<li><span>l\u2019\u00e9tat de la vessie ;<\/span><\/li>\n<li><span>les traitements d\u00e9j\u00e0 r\u00e9alis\u00e9s ;<\/span><\/li>\n<li><span>les priorit\u00e9s du patient concernant la r\u00e9cup\u00e9ration et la fonction sexuelle.<\/span><\/li>\n<\/ul>\n<p class=\"isSelectedEnd\"><span>La discussion entre le patient, l\u2019urologue et le radiologue interventionnel permet de d\u00e9terminer l\u2019option la plus adapt\u00e9e.<\/span><\/p>\n<h4><span>Une technique d\u00e9sormais utilis\u00e9e dans plusieurs h\u00f4pitaux britanniques<\/span><\/h4>\n<p class=\"isSelectedEnd\"><span>Plusieurs \u00e9tablissements du NHS disposent aujourd\u2019hui d\u2019informations d\u00e9di\u00e9es \u00e0 l\u2019embolisation de la prostate.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Royal Free London la pr\u00e9sente comme une technique mini-invasive permettant de traiter l\u2019HBP en bloquant les petits vaisseaux alimentant la prostate. University College London Hospitals la d\u00e9crit \u00e9galement comme une alternative \u00e0 la RTUP ou \u00e0 certaines interventions laser.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Cette int\u00e9gration dans diff\u00e9rents \u00e9tablissements hospitaliers britanniques montre que l\u2019embolisation prostatique fait d\u00e9sormais partie des options th\u00e9rapeutiques propos\u00e9es \u00e0 certains patients.<\/span><\/p>\n<p><strong>En r\u00e9sum\u00e9<\/strong><\/p>\n<p class=\"isSelectedEnd\"><span>L\u2019<\/span><strong><span>embolisation des art\u00e8res prostatiques est reconnue au Royaume-Uni comme une option de traitement de l\u2019hypertrophie b\u00e9nigne de la prostate<\/span><\/strong><span>.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Le NICE consid\u00e8re que les donn\u00e9es disponibles concernant son efficacit\u00e9 et sa s\u00e9curit\u00e9 sont suffisantes pour permettre son utilisation dans la pratique clinique, avec une s\u00e9lection adapt\u00e9e des patients.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Cette technique mini-invasive permet de r\u00e9duire progressivement le volume de la prostate par voie art\u00e9rielle, sans incision chirurgicale ni r\u00e9section du tissu prostatique \u00e0 travers l\u2019ur\u00e8tre.<\/span><\/p>\n<p class=\"isSelectedEnd\"><span>Elle peut ainsi constituer une alternative int\u00e9ressante pour certains hommes pr\u00e9sentant des sympt\u00f4mes urinaires li\u00e9s \u00e0 une HBP.<\/span><\/p>\n<p><span>Pour savoir si <\/span><strong><span>l\u2019embolisation de la prostate<\/span><\/strong><span> peut correspondre \u00e0 votre situation, un bilan personnalis\u00e9 permet d\u2019\u00e9valuer votre prostate, vos sympt\u00f4mes et votre anatomie art\u00e9rielle avant de discuter des diff\u00e9rentes options de traitement.<\/span><\/p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]\n","protected":false},"excerpt":{"rendered":"<p>Une prostate \u00e9largie Plus du tiers des hommes de plus de 50 ans ont une hypertrophie de la prostate, ce qui peut les rendre plus difficiles \u00e0 uriner.Des m\u00e9dicaments ou une op\u00e9ration peuvent aider, mais l\u2019Institut national pour l\u2019excellence de la sant\u00e9 et des soins estime qu\u2019il faudrait d\u00e9sormais offrir aux hommes une autre option [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":4305,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"795","footnotes":""},"categories":[401],"tags":[],"class_list":["post-1404","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-etudes-externes-sur-lembolisation-de-la-prostate"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - 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