Month: September 2022

Categories
Enlarged Prostate

Medications for an Enlarged Prostate

Selective alpha-blockers and 5-Alpha reductase inhibitors are usually the first choices of medication to treat benign prostate hyperplasia.

Selective alpha-blockers and 5-Alpha reductase inhibitors are usually the first choices of medication to treat benign prostate hyperplasia.

Alpha-Blockers are a type of blood pressure medication, that work by “blocking” the hormone norepinephrine (also known as noradrenaline) and thereby prevent the muscles in the walls of veins and smaller arteries from constricting. This allows these vessels to remain open and relaxed, and as a result, blood flow is improved and blood pressure is lowered.

Due to their ability to relax the muscles in the prostate and around the bladder, men taking this alpha-blocker may have an easier time urinating.

In fact, according to some studies, it is estimated that around 3 out of 5 men that take alpha-blockers find that their urinary symptoms improve within the first month of treatment.

In clinical studies, alpha-blockers have shown promising results in their ability to improve urinary symptoms related to BPH, and have proven to do so faster than another commonly prescribed medication for BPH, which is 5-alpha reductase inhibitors.

5-alpha reductase is what drives both normal and abnormal prostate growth. It is influential in the formation of dihydrotestosterone, also known as DHT, which is an androgen formed from testosterone.

Administering a 5-Alpha Reductase Inhibitor, such as finasteride and dutasteride, can inhibit the production of DHT and result in a decrease in prostate volume, as well as improvement in urinary issues.

In clinical studies, alpha-blockers have shown an ability to improve lower urinary tract symptoms related to an enlarged prostate and work faster than the 5-alpha reductase inhibitors at relieving these symptoms. However, alpha-blockers have not provided clinical evidence to support their effect on reducing the long-term risk of acute urinary retention, as well as the risk of needing to have prostate surgery.

Both alpha-blockers and 5-alpha reductase inhibitors result in different actions in the body, and the combination of these two types of medications is oftentimes considered synergistic.

According to a study published in Science Direct, which was originally published in The Journal of Urology, researchers found that combination therapy with an alpha-blocker and 5-alpha-reductase inhibitor provided a greater improvement in lower urinary tract symptoms compared to using one or the other medication solely.

In another study published in Science Direct,  researchers found that the combination of the alpha-blocker, tamsulosin, and the 5-alpha reductase inhibitor dutasteride, significantly reduced the risk of acute urinary retention, as well as reduced the need for prostate surgery.

This particular study followed 3195 men over a 4 year period and found that combination therapy reduced the risk of urinary retention and the need for prostate surgery by 66% when compared to the impact of the alpha blocker tamsulosin alone, and by 20% compared to dutasteride alone.

Though numerous studies have shown that combination therapy is more effective in treating both the symptoms and the prostate condition itself, combination therapy of alpha-blockers and 5-alpha reductase inhibitors does come with its increased risks of adverse effects.

In our next article, we will take a look at some of the side effects and risks associated with the combination therapy of alpha-blockers and 5-alpha reductase inhibitors.

Categories
Fibroids

Putting an End to Fibroids

There are many medications that can help relieve the symptoms of uterine fibroids. However, they provide a temporary solution.

There are many medications that can help relieve the symptoms of uterine fibroids, such as pelvic discomfort and heavy menstrual bleeding. However, these medicines do not remove the fibroids and only provide a temporary solution. Once the medication is stopped, the relief it provided from fibroid symptoms is stopped as well. Therefore the only way to successfully put an end to fibroid symptoms is to remove the fibroids.

There are several surgical approaches to removing uterine fibroids. One excellent option is a non-invasive procedure, called Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Another option is a major surgery such as a hysterectomy, or a uterine sparing surgical procedure, such as a myomectomy.

A myomectomy is usually offered as a treatment recommendation for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons. Whereas a hysterectomy is typically an option for women with fibroids that would like to avoid having to take medication and experience the side effects associated with them, as well as avoid the risk of fibroids returning following some of the other treatment procedures available. A hysterectomy is also oftentimes the preferred method of treatment of uterine fibroids for women that do not plan to have children.

Both a hysterectomy and a myomectomy are major surgery and come with their own risks of complications and side effects. Therefore it’s important to work with your doctor in preparation for either of these surgeries.

A myomectomy, in particular, has the potential complication of injury to internal organs and excessive bleeding. There is also the risk of the uterus becoming weaker after surgery, which carries its own set of problems.

Fortunately, there are certain things that can be done in preparation for surgery, that can help decrease the risks of complications, and lend themselves to a safer, more successful operation.

To minimize the risks during myomectomy surgery, your doctor may recommend:

Iron supplements and vitamins

Sometimes the fibroid side effect of heavy menstrual bleeding can lead to iron deficiency and anemia. In order to build up a patient’s blood count, your doctor might recommend taking iron supplements and vitamins for a period of time before the procedure.

Hormonal treatment

Some of the medications used to treat the symptoms associated with uterine fibroids, including anemia, can be an effective treatment to prepare the body for surgery. These medications include gonadotropic-releasing hormones ( GnRH agonists), and certain hormone-containing birth control pills. By blocking the production of estrogen and progesterone, and in some cases stopping menstruation entirely, these medications can help the body to rebuild hemoglobin and iron stores for a more successful surgery and recovery.

Medication to Shrink Fibroids

GnRH agonists are sometimes used to shrink fibroids prior to surgery. By shrinking the fibroids in preparation for surgery, the patient may not have to have an open procedure, and can instead have a minimally invasive surgical approach to remove the fibroids.

Though the research on this is mixed, there is some clinical evidence to support the effect that GnRH therapy can have on shrinking fibroids and decreasing heavy bleeding, to the point where surgery is no longer required. However, due to the side effect profile of these medications such as hot flashes, vaginal dryness, night sweats, and other symptoms of menopause, some women wish to avoid these GnRhH agonists altogether.

Other common pre-surgery recommendations may include:

  • Take a bath or shower before coming in for your surgery.
  • Abstain from applying any lotions, perfumes, deodorants, or nail polish.
  • Do not shave attempt to shave the surgical site yourself ( This may not be required by all doctors, however, it’s worth asking about).
  • Make sure to have someone that can drive you home, as the anesthesia and pain medication administered will make it unsafe to drive after the operation.
  • Be sure to remove any jewelry and piercings.

Lastly, and most importantly, make sure that you understand exactly what method of surgery is planned, as well as the risks, side effects, benefits, and potential complications involved.

If your doctor has suggested the use of medications that can shrink fibroids and reduce bleeding during surgery, make sure to ask about potential risks and side effects associated with these medications, as these medications aren’t necessarily the best option for everyone. In some cases, fibroid medications can shrink and soften fibroids so much so, that they become harder to detect and surgically remove.

It’s also important to be aware of all of the treatment options available to you because in some cases, a hysterectomy or a myomectomy might not be the best option, and your doctor may recommend a less invasive procedure such as Uterine Fibroid Embolization, which we specialize in here at our office.

If you are interested in finding out more about Uterine Fibroid Embolization as a treatment procedure for uterine fibroids, please feel free to call us today to set up a consultation.

There are many ways to treat uterine fibroids, call today and let us help you find the best one for you.

Categories
Knee Osteoarthritis

Enjoying the Fall, Pain Free

Though we can not control fluctuating temperatures during the changing of the seasons, we can take action to lessen the impact it can have on our bodies.

Though we can not control fluctuating temperatures during the changing of the seasons, we can take action to lessen the impact it can have on our bodies.

In our last article, we took a look at 5 simple ways to decrease weather-related knee pain, which were:

  • Turn up the heat and keep those joints warm by keeping your home warm.
  • Wear warm clothing to keep your body warm, especially when going outdoors, be sure to layer up.
  • Take warm showers and baths to help boost circulation and soothe achy joints.
  • Exercise even though it’s tempting to cuddle up under a warm blanket all day, by moving your joints, will help decrease joint pain, and make you feel better all around. If it’s too cold out, try walking on the treadmill, or swimming in an indoor pool.
  • Stretch those joints with some yoga, and light stretching. Even stretching for just 10 minutes is enough to make a positive impact.

All of these recommendations are effective and 100% doable, but it gets even better than that…because…there’s more!

Here are five more easy solutions to decreasing weather-related joint pain, so that you can enjoy the fall and all the joy and activities that can come with it.

1. Hydrate

Hydrate, hydrate, hydrate. Our muscles and bones are composed of a high percentage of water, and keeping them hydrated is crucial to the health and function of our bodies. If the weather is cold, try adding a few cups of tea to your daily water intake. Not only will this aid in hydration but it can also help warm up the body, which on a chilly day is definitely a win-win.


2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Depending on the severity and frequency of pain, you may wish to speak with your doctor about taking anti-inflammatory NSAIDs, like ibuprofen, on days when the fluctuating temperature is aggravating your joints. NSAIDs can be very helpful at reducing pain and inflammation in the short term, however, they can interact with many other medications, so it’s important to speak with your doctor or pharmacist first.


3. Get Enough Sleep

Being sure that you are getting enough sleep is important for overall health, regardless of the changing weather. However, this may mean that you’ll need to make some adjustments to your sleep routine due to the days getting shorter, and thereby getting darker, earlier.


4. Eat Healthy Nutritious Food

This one may be obvious in its benefits for overall health including knee health- however, its benefits can be particularly helpful for those of us that are sensitive to weather fluctuations. Eating a diet that is high in anti-inflammatory foods, like those found in the Mediterranean Diet, can help keep inflammation low and reduce joint pain, regardless of the weather.


5. Stay Positive

Staying positive doesn’t mean that you should ignore your knee pain, but it does mean that you can change your attitude about it.

When the body hurts, it’s trying to communicate with us. This is valuable information that we can be grateful for. This information could mean we need an extra layer or two, or maybe we need to rest more, eat better, call a friend, take a walk, watch a movie, and just plain take good care of ourselves. And when it comes to weather-related knee pain, stay positive by reminding yourself that this too shall pass.

The Bottom Line: No matter how your body responds to the ever-changing weather, there is always something you can do to help ease any pain and discomfort. That being said, if your joint pain is persistent and interfering with your life, it should definitely be addressed by speaking with your doctor, and seeing if any further treatment may be necessary

Fortunately, there are many excellent treatment options to reduce joint part, and in particular knee pain caused by osteoarthritis. One of the best treatment options is a procedure that we specialize in here at MidAtlantic Vascular and Interventional called Genicular Artery Embolization. To learn more about this procedure give us a call today.

In the meantime, as the weather changes from summer to fall, get out the sweaters, and the blankets, and make your favorite cup of tea. Then get ready to cuddle up with a good book, a movie, or a long chat with a friend, while you enjoy the relief that comes from keeping those knee joints warm and cozy.

Categories
Knee Osteoarthritis

Reducing Weather Related Joint Pain

Preceding every change in temperature comes a change in barometric pressure which can increase knee pain and stiffness.

“In the Spring, I have counted 136 different kinds of weather inside of 24 hours.”

– Mark Twain

Preceding every change in temperature comes a change in barometric pressure which can increase knee pain and stiffness.

So why is this?

The general consensus among experts is that the increase in joint pain that can precede a weather change is due to changes in barometric pressure. When it is about to rain, the barometric pressure decreases, and this decrease in air pressure can cause the tissue surrounding the joints to expand. As a result of the expanding tissue, muscles, and tendons, more pressure is put on the joints which can increase pain.

Unfortunately, there is nothing we can do to control the ever-changing weather, however, there are plenty of things we can do to lessen the impact that these changes can have on our bodies, and more specifically our knees.

Here are 10 things you can do to keep knee pain at bay during barometric pressure and temperature changes.

1. Keep your home warm.

This one may be a bit obvious, but it’s worth mentioning nonetheless.

Making sure to keep your heater running, and even turning it up a bit first thing in the morning, can help keep weather-induced swelling at bay. And, along with heating your home, some find using an electric blanket or a heating pad can be helpful to keep the body and joints warm.


2. Wear warm clothes

Another action that can help decrease joint paint is to wear warm clothes- especially if you plan to venture outdoors. This includes putting on a hat and gloves and making an effort to layer up. The warmer you keep your body, the less it will be impacted by the changing temperature and air pressure.

3. Take warm showers and baths

Taking a warm shower or bath can help boost circulation, and soothe achy joints as your body absorbs the heat. It can also calm the nerves and help relieve stress which can positively affect overall health and wellbeing.

4. Exercise

Though it’s tempting to just curl up under a warm blanket in a warm house, no matter what the weather, exercise is one of the best things to do to keep joint pain at bay.

Though it may feel uncomfortable to be active during cold and rainy low air pressure days, moving the body and the joints can reduce joint pain and stiffness.

Simply walking on a treadmill, swimming in a heated pool, and stretching in a hot tub can all be helpful.

5. Stretch

Light stretching can go a long way when it comes to relieving joint pain, even on rainy days. Even just 10 minutes of stretching can make a difference.

Try doing any of the aforementioned suggestions above, and you may find that your weather-related joint pain is greatly decreased- and your mood is increased as well.

Just because we can’t control the ever-changing weather, doesn’t mean we have to just deal with the additional joint pain and discomfort that can come with it.

These five things can definitely make a difference, and that’s not all!

In our next article, we will take a look at five more easy actions that can be done to decrease joint pain aggravated by fluctuations in barometric pressure and temperature. With a little awareness and a pinch of effort, these simple tasks can have you feeling better, no matter what the weather brings.

 

Categories
Enlarged Prostate

Dutasteride and BPH

The 5-alpha reductase inhibitor dutasteride is a medication that can treat benign prostate hyperplasia symptoms and reduce prostate size.

A medication that can treat benign prostate hyperplasia symptoms and reduce prostate size, is the FDA-approved 5-alpha reductase inhibitor dutasteride.

Dutasteride, also known by its brand name Avodart, works by inhibiting the 5-alpha reductase enzyme, by converting some of the body’s testosterone into dihydrotestosterone– which can cause further prostate growth.

The overproduction of dihydrotestosterone, also known as DHT, also plays a significant role in hair loss, leading to it also being FDA-approved to treat male pattern baldness.

The 5-alpha reductase inhibitor approved to treat male pattern baldness is finasteride, also known by its brand name Propecia or Proscar.

Though 5-alpha reductase inhibitors show promising results in their ability to shrink the prostate and reduce benign prostate hyperplasia symptoms, they are not without their own set of side effects and risks.

Some of the side effects of using dutasteride in the treatment of an enlarged prostate are dizziness, testicular pain, and swelling, as well as:

Decreased sex drive and other sexual problems

Increased risk of depression and anxiety

Increased risk of heart failure

Increased risk of diabetes and other metabolic diseases

Other serious side effects of dutasteride include:

  • Peeling Skin
  • Difficulty breathing
  • Increased breast size
  • Swelling of the face, tongue, or throat
  • Increased risk of prostate cancer

Dutasteride does come with its side effects and risks. In fact, this is not a complete list of side effects, and others may occur. Therefore it’s important to speak at length with your healthcare provider regarding all of these possible side effects as well as any drug interactions dutasteride may have.

For men that wish to avoid taking medication for an enlarged prostate due to the risks and side effects of these drugs, they may wish to explore the option of a non-invasive surgical procedure that we specialize in here at MidAtlantic Vascular and Interventional called Prostate Artery Embolization.

Please call us to learn more and set up a consultation.

Categories
Fibroids

Risks and Side Effects of a Myomectomy

There are several ways to remove fibroids. A myomectomy is a surgical procedure to remove uterine fibroids while keeping the uterus intact.

When fibroids are causing troublesome symptoms, and pain, and interfere with your normal activities, it is important to be aware that there are many treatment options available to relieve this burden. These treatment options can result in a decrease in symptoms, and in the case of a hysterectomy or a myomectomy, remove the fibroids completely.

Unlike a hysterectomy, which removes the fibroids by removing the entire uterus that contains them, a myomectomy is a surgical procedure to remove uterine fibroids, while keeping the uterus intact. Though it is actually more invasive than a hysterectomy, a myomectomy is an alternative to a hysterectomy for women that plan to bear children, or whose fibroids may be the cause of fertility issues.

As with all major surgeries, a myomectomy procedure does come with its own set of side effects and risks.

Some of which are:


Blood Loss:

Many women who undergo a myomectomy report an improvement in fibroid symptoms such as pelvis pressure and heavy bleeding. However, a myomectomy is still major surgery, and though it has a relatively low complication rate, the procedure still comes with its own unique set of challenges and risks.

One of the biggest risks involved in a myomectomy is the risk of excessive blood loss.

Many women with fibroids already have low blood counts and even anemia due to the fibroid symptoms of abnormally heavy menstrual bleeding. This, therefore, puts them at a much higher risk of problems due to blood loss.


Scar Tissue:

Due to the incisions that are done inside the uterus in order to remove fibroids, there is a risk of developing bands of scar tissue after surgery.


Pregnancy and Childbirth Complications:

Women of childbearing years may opt to have a myomectomy, especially over the option of a hysterectomy. However, a myomectomy can cause an increase in some risks during the delivery of a child. Though this is rare, it does happen and may result in a cesarean delivery to avoid rupturing the uterus during labor.


Increased Chance of a Hysterectomy:

Depending on the size, number, and location of fibroids, sometimes the surgeon may have to remove the uterus completely. Though this rarely happens, if the bleeding during a myomectomy becomes uncontrollable or there are additional abnormalities found in the uterus, sometimes the uterus needs to be removed as well.


Spread of Cancer:

During a myomectomy surgery, there is a very rare chance of a cancerous tumor being mistaken for a fibroid. As a result of trying to remove an unknown to be cancerous fibroid, there is the risk that it could lead to the spread of cancer.


Other potential risks and complications of a myomectomy are:

  • Hemorrhage
  • Injury to the uterus
  • Damage to the nearby organs of the urinary system
  • Infection
  • Blood clots
  • Eventual re-growth of fibroids

Though these risks and complications may be rare, they do happen. Therefore it’s important to be aware of them before deciding on any treatment plan.

In the end, you may find that both a hysterectomy and a myomectomy come with too many side effects and risks, and you may wish to learn more about a much less invasive procedure to remove fibroids, such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

In our next article, we will look at some of the things that can be done to help prevent possible surgical complications before choosing to have a myomectomy to remove uterine fibroids.

Categories
Knee Osteoarthritis

Pain Before the Storm

When it comes to the effect that an upcoming rainstorm can have on our joints, the research backing this occurrence is mixed.

When it comes to people experiencing an increase in knee pain before a rainstorm, the research backing this occurrence is mixed.

Maybe you’ve heard a relative or friend predict a rainstorm based on an ache in their joints, or maybe you’ve experienced it. Is it possible?

A recent study published in the British Medical Journal found no connection between rainy weather and increased joint pain. The researchers came to this conclusion by looking at more than 11 million medical visits that occurred on rainy days versus dry days and found that there was not only an increase during rainy days but there was in fact an increase on dry days. That being said, this could be due to people being more likely to cancel or postpone a medical visit during bad weather.

Another study published in Arthritis Care & Research, took a look at the weather at the time that the study participants first began to experience arthritis symptoms, and compared it to the weather a week or a month before the symptoms first appeared.

What they found was that there was no link between joint pain, rain, or temperature. However, further research has shown that the impact of the outside environment on joint pain is real, it just isn’t necessarily caused by the type of weather or the temperature. It’s caused by a change in something known as barometric pressure.

A study published in The American Journal of Medicine followed 200 patients for three months and found that their knee pain did in fact increase when the temperature dropped due to the drop in the air pressure.

Furthermore, another study that looked at 712 people with osteoarthritis, found that 469 people (69%) reported that their joint pain is weather sensitive. However, again, it wasn’t the type of weather or the temperature that caused this, but the change in barometric pressure.

So what is barometric pressure?

Barometric pressure is the measurement of air pressure in the atmosphere. More specifically it is the measure of the weight exerted by air molecules.

Barometric pressure is measured and analyzed by meteorologists so that they can track weather changes and predict storms. When the barometric pressure changes, the weather changes as well.

So how does a change in barometric pressure cause an increase in knee pain?

Though the exact reason for this increase in knee pain is unknown, most experts agree that a decrease in air pressure pushes less against the body, thus allowing the tissue to swell and expand. This expansion of tissue can thereby put more pressure on the joints, and cause an increase in pain, as well as tightness, stiffness, and overall discomfort.

Some of the other possible reasons for the increase in pain based on weather and barometric pressure changes are:

  1. The cartilage is worn down in the joints of those with knee osteoarthritis which exposes nerve endings. These nerve endings are sensitive to pressure changes and result in pain.
  2. Changes in barometric pressure can cause expansion and contraction of the ligaments, tendons, and cartilage within the joints. Which as a result, causes an increase in knee pain.
  3. The viscous fluid in the joints, which reduces friction between the bones actually becomes thicker in cold weather, which increases joint stiffness and pain.
  4. Cold and wet weather often causes people to be less active. Therefore without proper exercise, inactivity worsens joint pain and stiffness.

Fortunately, the impact that the changes in weather and barometric pressure have on knee pain is temporary. When these changes occur, our bodies will eventually either adjust to the change or return to normal when the air pressure increases.

Even though the research regarding a connection between weather changes and knee pain is not entirely clear in either direction, most doctors and people with knee osteoarthritis will agree that in their personal experience, a connection indeed exists.

Unfortunately, there is nothing we can do to prevent the weather and barometric pressure from fluctuating, however, there are things we can do to help lessen the impact that these changes have on our joints.

In our next article, we will take a look at a few simple things that can be done to decrease pain during times of air pressure fluctuation and temperature changes.

Categories
Enlarged Prostate

Finasteride: BPH and Male Pattern Baldness

Though originally used to treat benign prostate hyperplasia,  5-alpha-reductase inhibitors are now widely prescribed to combat hair loss. 

Though originally used to treat benign prostate hyperplasia,  5-alpha-reductase inhibitors are now widely prescribed to combat hair loss.

In fact, in 2020 around 2.4 million prescriptions were written for the 5-alpha reductase inhibitor finasteride, in order to treat male pattern baldness.

So what is a 5-alpha reductase?

5-alpha reductase is an enzyme that is present in the liver, skin, and prostate.

The role of this enzyme is to convert some of the testosterone, which is an androgenic steroid that is responsible for the growth seen during puberty, into dihydrotestosterone.

Dihydrotestosterone, also known as DHT, plays a significant role in male pattern baldness, the growth of facial hair, acne, and prostate growth. When the body is producing excessive DHT, this can lead to benign prostate hyperplasia, prostate cancer, and hair loss.

The 5-alpha reductase inhibitor finasteride is FDA approved for the treatment of male pattern baldness, whereas the 5- alpha-reductase inhibitor dutasteride, also known by its brand name Avodart is FDA approved for the treatment of an enlarged prostate.

Both of these medications work by inhibiting the production of the enzyme 5-alpha reductase which thereby reduces the production of dihydrotestosterone. However, they each affect different smaller enzymes called type 1 and type 2 isoenzymes.

The isoenzyme type 1 is found mainly in the liver and skin, and in smaller amounts in the prostate. Isoenzyme type 1 is inhibited by the 5-alpha reductase inhibitor finasteride. This particular medication, also known by its brand name Propecia, has been found to reduce DHT production by 70% and has resulted in a prostate size decrease of 18%. When taken to treat hair loss, finasteride takes at least 3 months to take effect, and up to sick months to effects the prostate size.

The isoenzyme type 2 is found mainly in the prostate, with small amounts found in the skin and liver. Both the 5-alpha reductase isoenzymes type 1 and type 2 are inhibited by the medication dutasteride. Dutasteride, also known by its brand name Avodart, has been found to reduce dihydrotestosterone production by a whopping 93%, and in clinical trials decreased prostate size by 25.7%.

Though both dutasteride and finasteride are effective in both treating male pattern baldness and decreasing prostate size, finasteride does not stay in the system as long as dutasteride. Thus making dutasteride a better choice for benign prostate hyperplasia.

Finasteride and dutasteride are both taken as daily oral medication. Finasteride is available in 1 mg and 5 mg tablets, with the usual dose for male hair loss being 1 mg once daily, and 5mg daily for an enlarged prostate. Dutasteride is available as a 0.5 mg capsule and the usual dose for treating an enlarged prostate is 0.5 mg once daily.

Though 5-alpha reductase inhibitors are effective at shrinking the prostate and reducing benign prostate hyperplasia symptoms, they are not without their own set of side effects and risks.

In our next article, we will take a look at the side effects and potential risks involved in taking these medications.

Categories
Fibroids

Removing Fibroids Permanently

A hysterectomy is still the only definitive treatment option for removing fibroids permanently. A myomectomy is a uterine-sparing treatment.

Even with all of the treatment options available to women with uterine fibroids, a hysterectomy is still a preferred treatment method, due to the fact that it is currently the only definitive treatment option for removing fibroids permanently. However, since the procedure removes the uterus and cervix, a hysterectomy is not an option for women that would like to have children.

Though medication can help relieve the symptoms of fibroids, and most likely will not interfere with fertility, it does so as a temporary fix and is not a solution to the fibroid problem.

The only way to successfully remove fibroids is through a non-invasive surgery such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Or through a major surgery such as a hysterectomy, as well as a uterine sparing surgical procedure called a myomectomy.

A myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact, thereby preserving fertility.

A myomectomy is usually offered as a treatment recommendation for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons. The procedure can also help regulate abnormal uterine bleeding caused by fibroids, as well as other fibroid-related symptoms.

Remove the fibroids, and remove the symptoms.

Depending on the number of fibroids, their location, and their size, a surgeon will perform a myomectomy operation with one of three approaches.

The first approach is a standard open surgery, while the second and third options are less invasive.

Let’s take a look at what those operations are.

Laparotomy: 

A laparotomic myomectomy is performed as open surgery, by way of an abdominal incision. Though effective, due to its invasiveness, a laparoscopic myomectomy has a higher risk for blood loss and scarring, which can be problematic.

A laparotomic myomectomy is usually necessary when there are several very large fibroids that are located in a difficult area of the uterus to reach using other surgical methods. It is also oftentimes the best approach to removing intramural fibroids.

–     Intramural fibroids are located primarily within the width of the uterus. There are several types of intramural fibroids: anterior intramural fibroids, which are located in the front of the uterus, posterior intramural fibroids, which are located in the back of the uterus, and a fundal intramural fibroid, located in the upper part of the uterus.

Because intramural fibroids grow toward the outside of the uterus, if they are too large, they can cause fertility issues and pregnancy complications.

Hysteroscopy:

During a hysteroscopic myomectomy, fibroids are removed using a surgical instrument called a hysteroscopic resectoscope.

This hysteroscopic resectoscope enters the uterine cavity through the vaginal canal, and it is usually the preferred method for removing submucosal fibroids.

–     Submucosal fibroids are located near the outer layer of the uterus, however, they grow toward the internal layer of the uterus, called the mucosa, causing them to protrude into the uterine cavity. These fibroids tend to be symptomatic even at smaller sizes, and can even impact fertility. However, when caught early, these fibroids can be removed, thus preventing fibroid-related issues during pregnancy

Laparoscopy:

A laparoscopy is similar to a hysteroscopy, only it is less invasive and typically an option for women who have a small number of subserosal fibroids.

–     Subserosal fibroids are located near the outer layer of the uterus, known as the serosa. This particular type of fibroid grows toward the outside of the uterus. When they are small, they are unlikely to cause symptoms and usually do not require treatment. However, they should be monitored in case they become larger and therefore symptomatic.

Both the hysteroscopy and the laparoscopy have a much faster recovery time than a laparotomy, as they are less invasive than open surgery.

As with any surgery, a myomectomy does come with its risks.

Every reproductive organ is a very serious surgery, and none of the methods of a myomectomy are immune to their own set of risks, side effects, and complications.

In our next article, we will take a look at some of the risks of a myomectomy and provide more information on each procedure.

Categories
Knee Osteoarthritis

Drinking Water For Your Health

You may want to drink a few extra glasses of water once you find out the benefits it can have on your health and your knees.

Before you reach for that morning cup of coffee, you may want to drink a glass of water, especially when you find out the benefits this can have on your health, including your knee osteoarthritis.

Drinking adequate amounts of water, as most of us already know, has many health benefits. It keeps our skin healthy and clear, it helps control our blood pressure, and it helps us maintain a healthy digestive system. Staying hydrated can also aid in the prevention of kidney disease, help with weight loss and weight management, it can boost our energy levels, and improve our mood. And, on top of all that, drinking enough water can help support our joints and reduce osteoarthritic knee pain.

All of that from just drinking water?

Yes.

Today, let’s focus on the effect drinking enough water specifically has on the health of our knees.

Believe it or not, most of the water in our bodies is stored in our connective tissues and joints. This means that it is critical for our tendons, ligaments, etc, to be supplied with enough water, as it lubricates these joints and flushes out toxins. This also means that when you’re dehydrated, these joints can become inflamed, and cause a dramatic increase in knee pain.

One of the ways water helps the knees specifically is through its ability to help create synovial fluid.

Synovial fluid is a thin layer of fluid that provides essential nutrients to the joints and keeps them lubricated. And, according to a study published by the Journal of The National Library of Medicine, this fluid also reduces friction created when moving the joints. Without enough water, this friction increases and leads to more knee pain.

Making sure you are getting enough water, is also crucial for your cartilage.

Cartilage is the strong and flexible tissue that covers the ends of our bones. Protecting the bones, cartilage allows the bones to glide over each other, rather than rubbing against one another. In fact, it is estimated that roughly 65 to 80 percent of our cartilage is made up of water. Therefore, by drinking enough water, the cartilage stays hydrated and soft, and the production of synovial fluid is stimulated, thus decreasing pain and reducing inflammation.

Proper hydration also supports the blood supply needed to keep the body working properly, and thereby protects our organs. It also helps our muscles to function properly- which in turn, helps with our joint function which increases mobility and decreases knee pain.

So how much water should we drink to get these benefits?

Well, before you go chugging glass after glass of water, it’s important to know that though the recommendation is about 1 to 1 1/2 liters of water a day- this water shouldn’t be consumed all at once. Instead, medical experts recommend staying hydrated gradually, throughout the day.

Experts also agree that the best time to get that first full glass of water is first thing in the morning. After a night of sleep, the body hasn’t been getting any hydration, so it’s important to start the day by beginning to replenish the supply.

Furthermore, experts recommend that we should aim to drink a cup of water with each meal, in between each meal, and always drink water before and after exercise. It is also recommended to carry a water bottle with you, as a reminder to drink water, and for an easy-to-access source of it.

The main objective of drinking enough water is to increase the health and healing abilities of the body- And, of course, to prevent dehydration. The side effects and risks associated with dehydration can wreak havoc on your body and your day-to-day life.

Some of the side effects of dehydration include:

– Headache
– Dizziness or lightheadedness
– Sleepiness
– Decrease in urination
– Dark yellow- or amber-colored urine
– Decreased skin elasticity
– Dry mouth and mucous membranes (lips, gums, nostrils)
– Low blood pressure

Not only can dehydration cause those side effects, but it can be specifically harmful to the knees and cause:

Loss of Joint Lubrication: Water is a major component of the synovial joint fluid which prevents friction between the ends of bones and enables smooth painless movement.

Reduced Shock Absorption: Water makes up greater than 70% of the cartilage tissue which acts as a shock absorber during high-impact activities such as jumping and running.

Increases Muscle Cramping: Dehydration can cause muscle spasms and cramping leading contributing to joint pain.

Joint Degeneration: Chronic dehydration can result in loss of blood volume sparking of chain reaction resulting in overall functional decline and joint degeneration.

Fortunately, dehydration can be avoided.

All it takes is a little awareness, and a little extra effort to make drinking water a part of your daily life. It may take some getting used to, especially if you’re not in the habit of keeping a water bottle with you, however with some practice, it can easily become a part of your day-to-day routine.

So next time, don’t wait until you’re thirsty to get that glass of water. Instead, start your day with it, and go from there.