Prof. Tiago Bilhim

QualihealtH is presenting an innovator procedure to help patients with Benign Prostatic Hyperplasia (BPH). It is called Prostatic Arterial Embolization (PAE) and it has been shown to be safe and effective inducing prostatic volume reduction in patients suffering from BPH. The procedure is minimally invasive (without any incision and leaving no scar) and is performed under local anesthesia, without pain or other symptoms, with short hospitalization, immediate improvement and short recovery. Hospitalization only lasts a few hours and almost all patients go home after dinner, if the blood pressure is normal, even if they live several hundred kilometers away from Lisbon. In this period, there will be a permanent contact with the medical team to assess complaints or clarify any doubts. The excellence of the procedure is due to a multidisciplinary team led by Professor Martins Pisco and Professor Tiago Bilhim, renowned physicians, pioneers in this field. Medical teams are coming all over the world to learn from Dr. Pisco about this procedure. Embolization is a very safe technique, with a very large success rate and unlike the prostatectomy, in which some patients are left with sexual dysfunction, sexual function is not affected in Embolization. None of the 1000 treated patients had sexual function affected. Actually, the sexual performance improved in about a third of the treated patients and in the remaining persisted as it was.

Introduction Uterine fibroids (leiomyomas or myomas) are the most common benign tumor in women and may cause heavy menstrual bleeding, pelvic pain and pressure related symptoms such as urinary incontinence, urinary frequency and pressure over the bladder. They may be a cause of infertility or cause pain during sexual intercourse. They arise in the uterus wall and according to their location they are submucosal, intramural or subserosal. They may be single or, most frequently, multiple. The size range goes from millimeters to over 20 cm. Traditional Treatment The traditional treatments are both medical and surgical. The medical management includes birth control pills, non-steroidal anti-inflammatory drugs and hormones. Surgical treatment includes miomectomy (fibroid removal) and hysterectomy (uterus removal). As an alternative, uterine fibroid embolization (UFE) has been performed with outstanding results. Pre-procedure consultation The patients are studied at outpatients clinic in which the risks and results are explained and a small brochure with all information is given to the patients. They should have a pelvic Magnetic Resonance, performed always in the same office for good quality, blood count, follicle stimulating hormone and estradiol tests. The patients should have a pelvic examination by a gynaecologist in the previous 6 months to the procedure. Preparation for the procedure As a pre-embolization medication, at home, the patients have on the previous day, at breakfast and dinner, and on the day of the procedure, at breakfast, an acid gastric mucosae protector, an anti-inflammatory, an ansiolytic and a stool softener. The day of the procedure they should take a good breakfast and they can eat and drink whatever they want. They are advised to arrive to the hospital 2 hours before the procedure. During this time an intravenous line is placed in the arm for saline and medications. The patients are asked to fill a questionnaire concerning the qu