Month: September 2022

Categories
Fibroids

Side Effects and Risks of a Hysterectomy

A hysterectomy is one of the treatment options for women with uterine fibroids. It comes with its own set of side effects and risks. 

As we’ve covered in our previous articles, a hysterectomy, which is the surgical removal of the uterus and cervix, is one of the treatment options for women with uterine fibroids. And, like all surgeries, it comes with its own set of side effects and risks.

One of the benefits of having a hysterectomy is that in removing the uterus, the fibroids are also removed. In doing so, not only are the fibroids eliminated but so is the possibility of them growing back. To put it frankly, no more uterus, no more fibroids.

Women that would like to avoid having to take medication and experience the side effects associated with them, as well as women who would like to avoid the risk of fibroids returning following some of the other treatment procedures available, may wish to explore this option. However, it’s important to keep in mind that a hysterectomy is a major surgery and it is not without its own side effects and risks.

So let’s take a look at some of the potential side effects and risks of having a hysterectomy, as well as what can be expected in regard to the recovery period following the procedure.

A hysterectomy is a surgical procedure in which the uterus and cervix are removed through either an incision in the abdomen or belly button, or it is done vaginally. The procedure typically takes 1-3 hours and requires a spinal or epidural anesthetic that numbs the lower parts of the body, and it also may involve the use of a general anesthetic to put the patient to sleep during the surgery.

Once the surgery is complete, the recovery period can be rather difficult. A post-surgery hospital stay is necessary for up to five days. Then, once home, it can take roughly 6-8 weeks of rest to fully recover.

Some of the most common side effects associated with having a hysterectomy are vaginal drainage that may occur up to six weeks after surgery, and irritation at the surgical incision sites.
Other side effects may include:

– Blood clots.
– Hemorrhage.
– Infection.
– Injury to other surrounding organs including the bladder, ureter (the tube that connects the kidney to the bladder), intestines, muscles, nerves, or blood vessels.
– Formation of a fistula (an abnormal connection between the vagina and bladder).
– Allergic reactions to the anesthetic, pain medication, adhesives, or skin prep used during the procedure.

If the hysterectomy involves removing the ovaries and fallopian tubes, side effects such as menopausal symptoms are often experienced.

These include:

– hot flashes
– vaginal dryness
– loss of libido
– insomnia

It’s also important to understand that a hysterectomy is not reversible, it is permanent. After a woman has a hysterectomy, she will no longer have a period, and will no longer be able to bear children. For this reason, as well as others, many women experience emotional side effects from having a hysterectomy. The surgery has also been associated with an increased risk of long-term mental health issues. This is especially true of depression and anxiety.

The bottom line: If you are considering a hysterectomy, it is important to speak with your doctor about your concerns. In this day and age, a hysterectomy is far from the only surgical option for removing fibroids. In fact, there are several surgical procedures to remove fibroids while sparing the uterus- which is especially important for women who would like to have children, and for women that would prefer to avoid having major surgery.

In our next article, we will take a look at a uterine-sparing surgical procedure to remove uterine fibroids called a myomectomy.

 

Categories
Enlarged Prostate

Phenoxybenzamine: A Permanent Solution?

Other alpha-blockers, cause a return of symptoms once the medication is discontinued, however, the effect of phenoxybenzamine is permanent.

Other alpha-blockers, cause a return of symptoms once the medication is discontinued, however, the effect of phenoxybenzamine is permanent.

Phenoxybenzamine was one of the first alpha-blockers studied for its ability to reduce some symptoms of an enlarged prostate.

As a non-specific alpha-blocker, early studies reported that phenoxybenzamine successfully relaxes the urethra and reduces the frequency of urination in patients with BPH.

Though lower doses of phenoxybenzamine may be used to relieve bladder obstruction before surgery, it is rarely used in the treatment of BPH due to its adverse effects.

Some of the side effects and risks of using phenoxybenzamine are:

– stuffy nose
– mild dizziness or drowsiness
– blurred vision
– trouble having an orgasm
– upset stomach
– tired feeling.
– impotence
– ejaculatory dysfunction
– fainting
– fast heartbeat
– vomiting

Phenoxybenzamine also carries the potential risk for irregular absorption and mutation, which can cause adverse effects and permanent damage.

Another downside to phenoxybenzamine is that, just like the other alpha-blockers, phenoxybenzamine does not reduce the size of an enlarged prostate, but rather treats some of the urinary symptoms. However, there is a class of medications that can shrink the prostate itself. These medications are known as 5-alpha-reductase inhibitors.

Medication is not for everyone, and many find that a non-invasive procedure such as Prostate Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional is a better fit.

However, medication is still worth being knowledgeable about, especially if your provider has suggested it as part of your treatment plan. It’s important to know what these medications do, as well as their benefits and their risks.

In our next article, we will continue our look into medications that are used to treat the symptoms of BPH, by focusing on the use of 5-alpha-reductase inhibitors in the treatment of an enlarged prostate.

Categories
Enlarged Prostate

Alpha Blockers Types, Benefits, and Side Effects

Alpha-Blockers can reduce urinary symptoms by relaxing the muscles in specific areas of the urinary tract, such as the bladder and neck. This makes them a useful medication for treating urinary issues caused by an enlarged prostate.

The alpha-blocker that is most commonly used for bph urinary issues is Tamsulosin. Which is also known by its brand name Flomax.

Tamsulosin, as well as the alpha-blockers alfuzosin (Uroxatral), and silodosin (Rapaflo), are known as selective alpha-blockers that focus primarily on relaxing the tissues of the urinary tract. Whereas doxazosin (Cardura), and terazosin (Hytrin), are non-selective alpha-blockers that can affect both the urinary tract and other tissues located elsewhere in the body.

One of the benefits of using alpha-blockers such as tamsulosin (Flomax) is that they work quickly.

In fact, some patients taking tamsulosin may notice a difference within days of starting the medication. However, for those that are prescribed non-selective alpha-blockers like doxazosin and terazosin, their effectiveness can take time, as these medications have to be started at a very low dose and slowly titrate up so as to avoid causing low blood pressure.

Like all medications, alpha-blockers do come with their share of side effects.

The most common side effect reported is dizziness, however, this usually passes once the body adjusts to the medicine. That being said, it is wise to refrain from driving or using any heavy machinery while first adjusting to alpha-blockers due to this common side effect.

  • Other common side effects may include:
  • feeling dizzy or sick (nausea)
  • having a headache when you stand up
  • tiredness or fatigue
  • reduced libido
  • pounding heartbeat
  • a blocked nose
  • problems getting or keeping an erection (erectile dysfunction)
  • dry orgasm (where little or no semen is released during orgasm)

Because alpha-blockers lower blood pressure, there is also the risk of experiencing the side effects associated with this, especially if the dosage is too high.

  • Symptoms of low blood pressure from alpha-blockers include:
  • Nausea
  • Dehydration
  • Unusual thirst
  • Poor concentration
  • Blurry vision
  • Shallow breathing
  • Rapid breathing
  • Fatigue
  • Pale skin

Patients taking alpha-blockers to treat the symptoms of an enlarged prostate also risk experiencing sexual side effects from the medication. Though sometimes alpha-blockers can improve erectile function if the dose is too high and as a result blood pressure is too low, erectile dysfunction can occur.

Alpha-blockers can have dangerous interactions with many other medications. Alpha-blockers should not be taken with beta-blockers, calcium channel blockers, medications for erectile dysfunction, and more.

It’s also important to note that while alpha-blockers lower blood pressure and have been shown to improve total cholesterol- some research has found that these medications can actually increase the risk of heart failure. So be sure to talk to your doctor about any of these concerns.

When it comes to taking medication to reduce the symptoms of an enlarged prostate it’s important to make sure the benefits outweigh the potential side effects and risks involved.

Some men find medication to be very beneficial, while for others, a more permanent solution is preferred- such as surgery or a non-invasive procedure such as Prostate Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

For those men that do choose to take medication, alpha-blockers are not the only option. In our next article, we will take a look at another class of medications used to treat an enlarged prostate, 5–alpha-reductase inhibitors.

Categories
Fibroids

Hysterectomy: Is This Treatment Option Right For You?

Depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Though hysterectomy surgery was once common practice for women with fibroids, today there are many different options. However, depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Therefore, today let’s dive deeper into this surgical procedure, and cover the different types of hysterectomies, as well as reasons why some women might elect to have this operation.

There are three different types of hysterectomies, and they are:

  • Supracervical hysterectomy: During this procedure, surgeons remove the uterus but not the cervix. A doctor may also refer to this procedure as subtotal or partial hysterectomy, it is most often used to treat conditions such as endometriosis.
  • Radical hysterectomy: This surgery removes the uterus, cervix, and surrounding support tissue. Doctors often recommend this type of hysterectomy for people with cancer.
  • Total hysterectomy: This surgery involves the complete removal of the uterus and cervix. This can be used to treat many conditions, such as heavy menstrual bleeding, and uterine fibroids.

It’s also important to note that depending on the circumstances surrounding the need for a hysterectomy, the surgeon may also remove the ovaries (oophorectomy) and the fallopian tubes (salpingectomy).

Though there are some promising medications available, such as the Gonadotropin-releasing hormone (GnRH) agonists Lupron, Synarel, and Zoladex which can shrink fibroids and reduce fibroid-related heavy bleeding- some women would prefer a permanent surgical procedure such as a hysterectomy, so as to avoid having to take these medications due to their side effects and risks.

In fact, it is estimated that 40% of women taking GnRH agonists experience side effects such as:

  • hot flashes
  • mood changes
  • increased sweating
  • muscle stiffness
  • vaginal dryness

And the most concerning side effect of GnRH agonist therapy,  osteoporosis.

Other medications that are used to treat fibroids are:

  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps.
    – Given that some of the most commonly prescribed birth control pills can increase estrogen and therefore increase the size of fibroids, birth control is not always the best solution.
  • Progesterone-containing agents: Pills, implants, injections, or an intrauterine device (IUD) — may also control bleeding.
    – If the fibroids are small, and the symptoms are mild, a progesterone-containing birth control pill may be beneficial in reducing symptoms. However, they come with their own set of side effects, and they can sometimes mask the severity of fibroids and other underlying conditions.
  • Elagolix: A combination of a GnRH agonist, estradiol, and norethindrone that has proven to be effective at reducing fibroid symptoms with a lower risk of adverse problems that can come from GnRH agonists alone.
    – Elagolix interacts with several other medications, and if taken long-term can cause permanent bone loss.
  • Tranexamic acid: An antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids.
    – Though it is a nonhormonal option to reduce menstrual blood loss, it does not affect or address the underlying cause of the bleeding- which is the fibroids themselves. It is also expensive.

Medications can be effective at managing fibroid symptoms, however, they do so, as a temporary solution. Medications do not fix the problem and sometimes they can even make things worse.

Therefore the main benefit of having a hysterectomy is that it doesn’t just manage fibroid symptoms, but by surgically removing the uterus, it removes the fibroids completely.

Not only does a hysterectomy remove fibroids and eliminate any possibility of them returning, but it also eliminates any possibility of having children.

For women that would like to have children, medication may be a good option to help manage fibroid symptoms allowing them to postpone a hysterectomy.  Or they may opt to have a uterine-sparing procedure done such as a myomectomy or Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: For women with severe fibroids, fibroids that keep coming back, and fibroids that haven’t responded well to medication or other procedures, a hysterectomy may be an option worth considering. That being said, just like with medications, having a hysterectomy isn’t without its own set of side effects and risks. In our next article, we will take a look at what those are.

 

Categories
Knee Osteoarthritis

Soda and Knee Osteoarthritis

There is a connection between the development of knee osteoarthritis and the regular consumption of soft drinks.

Research has shown a connection between knee osteoarthritis and the regular consumption of soft drinks.

In one of the studies that found this connection, the researchers kept track of the amount of soda consumed by 2,000 men diagnosed with knee osteoarthritis, over a four-year period.

After years of regularly measuring their cartilage and accessing their knees health, the team of researchers found that the men with the fastest progression of knee osteoarthritis were indeed those that drank the most soda.

It’s easy to assume that the connection between drinking soda and worsening knee osteoarthritis is related to the connection that drinking soda has to weight issues and obesity. Of course, there is a research-backed connection between soda consumption and obesity. And, there is a research-backed connection between obesity and an increased risk of knee osteoarthritis. However, the results of the aforementioned study found that amongst the 2,000 men with knee osteoarthritis that drank soda, the men with the worst progression, were not necessarily overweight or obese. In fact, weight had little to do with it.

Most researchers purport that the reason behind the adverse relationship between soda drinking and worsening knee problems is the amount of refined sugar in these beverages. The high sugar content in soda causes a spike in blood sugar which creates stress on the body and as a result, triggers inflammation. In the case of daily soda drinking, this inflammation can become chronic.

At this point, you might be thinking, “Ok, that all makes sense, but this study looked only at men. So what about women with knee osteoarthritis that drink soda? Does it adversely affect them as well?”

Why, yes. Of course, it does. Furthermore, thanks to the research studies that looked at the impact of soda drinking on women’s health, we now have a better understanding of the intricacies of the relationship between high sugar content and inflammation. It involves a little something called uric acid.

Uric acid is a waste product found in our blood, that usually dissolves and passes through the kidneys, and then leaves the body through urine. Uric acid is created when the body breaks down chemicals called purines, which are found in some food and drinks.

Soda is high in purines due to its high fructose content, which causes the body to respond by creating more uric acid. Too much uric acid in the body leads to the production of crystals that are deposited in the joints, resulting in inflammation, increased pain, and can even cause gout, which is a form of very painful arthritis.

According to a study published in the Journal of the American Medical Association, women who consume soda on an almost daily basis, have a 75 percent higher risk of experiencing inflammation and even joint damage from uric acid.

And it gets even worse.

A study conducted at Tufts University found that women who consume three or more sodas a day have a bone density that is nearly 4% lower than those who do not drink soda. Not only does this decrease in bone density exacerbate osteoarthritis, but it also greatly increases the risk of osteoporosis. Yikes.

So what does this mean? No more soda…ever?

Though that’s probably a good idea, depending on your particular health issues, most doctors will agree that drinking soda on occasion is usually ok. However, for those of us with knee osteoarthritis, soda consumption should be extremely limited and exist only as a very minor part of an overall healthy diet.

That being said, given the connection between soda and obesity, diabetes, osteoporosis, and increased knee osteoarthritis, the best bet for all of us may be to reach for a cool crisp glass of water instead.