Month: October 2022

Categories
Enlarged Prostate

Urinary Symptoms and Sexual Dysfunction

The Mayo Clinic Proceedings published the results of a study that looked at the link between BPH urinary symptoms and sexual dysfunction.

The periodical Mayo Clinic Proceedings published the results of a study that looked at the link between common BPH urinary symptoms and sexual dysfunction.

Researchers studied 2,115 men between the ages of 40 and 79, by having them complete a questionnaire about their sexual function and urinary tract symptoms every two years.

What they found was that sexual function and urinary tract symptoms were indeed related. To put it simply: The greater the urinary symptoms, the lesser the sexual function.

The study also found that the urinary tract symptoms caused by an enlarged prostate that were most associated with sexual dysfunction were:

–  A feeling of urgency

–  Needing to get up multiple times at night to urinate

–  A weak urine stream

–  Straining to start urinating

These urinary symptoms were all associated with:

–  Difficulty getting or maintaining an erection

–  The way men felt about problems with sexual drive, erection, and ejaculation

–  Sexual satisfaction problems

So the solution is to treat the urinary issues caused by BPH, and then as a result, sexual function will improve?

Well, it’s not that simple.

Though there are many ways to treat the urinary symptoms caused by an enlarged prostate, some of these treatment methods can actually make things worse, or even cause sexual dysfunction.

In fact, some drugs that are commonly used to treat benign prostate hyperplasia, can actually cause erectile dysfunction and reduce sperm count.

Though prescription drugs are often very good at improving the symptoms of BPH, they do not tackle the real problem, and they can cause their own set of problems, such as ED.

In order to avoid such issues, some men may resort to surgery. However, it’s important to keep in mind that this too can come with the risk of sexual problems.

Many of these surgical procedures for men with an enlarged prostate, can increase the risk of inadvertently damaging structures around the penis which can lead to erectile dysfunction and other problems.

In our next article, we’re going to dive deeper into the connection between BPH treatment methods and sexual dysfunction.

In the meantime, if you’d like to learn more about Prostate Artery Embolization, an outpatient procedure with proven results without the risk of sexual issues, please call us and schedule a consultation today!

 

Categories
Fibroids

UFE: An Alternative to Surgery

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. UFE also has a shorter recovery.

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. It can also be an alternative to a major surgery such as a hysterectomy or a myomectomy, and has a much shorter recovery time. 

Unlike major surgery to remove fibroids which can require a few nights in the hospital and several weeks or even months to fully recover- UFE is an outpatient procedure, with a much shorter recovery time.

During UFE, a tiny catheter is inserted through a blood vessel in the leg or wrist, which is then guided to the blood vessels that feed the fibroids. Once it reaches that point, small particles are injected into the vessel to block the artery and cut off the blood flow to the fibroids.  Then, following the procedure, the patient will return to their home, where over the next few weeks and months, the fibroids will gradually shrink.

One of the many benefits of Uterine Fibroid Embolization is that it targets all fibroids in the uterus. This makes it an excellent treatment option for individuals with only a few fibroids as well as those who have many fibroids, regardless of fibroid size.

In fact, uterine fibroid embolization is so effective that most individuals who undergo the procedure have a dramatic improvement in their symptoms that is experienced when they return to their normal activities a mere 8 to 10 days after the treatment.

So what does it feel like? Does it hurt?

Good question, and we’ll do our best to answer that.

The UFE procedure itself is not painful, however light sedation medications will be administered through an IV in order to prevent any discomfort.  Some women report experiencing a feeling in their pelvis similar to menstrual cramping or heaviness. This is completely normal and is due to the decreased blood supply to the uterus.

Following the procedure, it is also normal to experience low energy, intermittent nausea, and possibly fever- as a result of the dying fibroid tissue.

These symptoms typically last a few days at most, and gradually decrease in severity. Most women report that by the fourth or fifth day following the procedure, they feel back to normal, while some might have a few more days of cramping. Fortunately, most of this discomfort can be easily ameliorated with the help of over-the-counter pain medication.

Since UFE is an outpatient procedure, it’s important to have an area in your home where you can relax and heal after.

You may wish to set up your bed with extra pillows, and your favorite blanket, and if there’s a tv in your relaxation location, having the remote control nearby can be helpful as well.

While resting at home, some cramping can be expected in the lower abdominal region for about 24 hours but will subside quickly. However, most physicians do recommend that patients plan to stay home or at least limit their activities for at least one week following uterine fibroid embolization.

Other restrictions that your doctor may ask you to follow are:

– No bathing for 2 weeks. Shower as normal.

– No tampons for at least one full cycle.

– Abstain from sex for 2 weeks.

– No heavy lifting until your strength fully returns.

– Flights and travel are not recommended for at least 2 weeks.

– Refrain from taking aspirin for at least the first week.

Though recovery times may vary, most patients can return to all normal activities after 2 weeks. Even better, they can expect to experience significant improvements in their pre-op fibroid symptoms, over the course of one to three months. This means no more heavy periods, pelvic pain and pressure, urinary incontinence, or pain during sexual intercourse.

In our next article, we will take a look at the results of the embolization, and the experience and time it usually takes for the fibroids to shrink.

In the meantime, if you are considering Uterine Fibroid Embolization treatment for uterine fibroids, or have any questions about the UFE procedure, please call us at 301-622-5360 and request an appointment at MidAtlantic Vascular and Interventional today!

Categories
Knee Osteoarthritis

Knee Injections: Do They Work?

Knee osteoarthritis is painful and can cause a decrease in mobility, and it puts limits on what you can do. Can knee injections help?

Knee osteoarthritis is painful and can cause a decrease in mobility that puts limits on what you can do. Therefore many people turn to knee injections to help relieve this pain.

So what are knee injections? And do they work?

When physical therapy and pain medication taken by mouth fail to relieve the aching pain caused by osteoarthritis of the knee, sometimes doctors will recommend an injection of medicine directly into the arthritic joint. These injections of medicine can reduce inflammation and relieve pain.

The most common type of knee injections are corticosteroid injections and hyaluronic acid injections. Let’s take a look at what these medicines are and how they work, starting with corticosteroid injections.

Corticosteroids are synthetic drugs that closely resemble cortisol- which is a hormone that is naturally produced by the adrenal glands and regulated by the pituitary gland inside the brain.

Cortisol is essential for life, as it helps to maintain blood pressure, immune function, and the body’s anti-inflammatory processes.

Cortisol can also:

–  help the body manage stress

–  convert protein into glucose to boost flagging blood sugar levels

–  work in tandem with the hormone insulin to maintain constant

–  blood sugar levels

–  reduce inflammation

–  contribute to the maintenance of constant blood pressure

–  contribute to the workings of the immune system.

Corticosteroid is a synthetic cortisol that is also used to help relieve knee pain by treating inflammation that is responsible for swelling and pain. Once injected into the knee, corticosteroids work quickly to temporarily relieve knee osteoarthritis pain.

The temporary pain relief from a corticosteroid injection can be helpful if a person with knee pain needs to engage in physical therapy, attend to an important life event, or postpone knee replacement surgery or genicular artery embolization to a later, more convenient time.

That being said, the key word here is temporary.

Though these injections can be helpful, they do not treat the knee condition itself, but rather provide short-term, temporary relief. Relief, that over time, will wear off completely.

It’s also important to note that just like any medication-related treatment, corticosteroid injections do not work for everyone. And, even when they are effective, the results may vary.

Some studies show that on average, just 40% of patients feel better after receiving cortisone shots for knee osteoarthritis.

In one study, one month after undergoing treatment, people who received cortisone injections were asked to report and rank their improvements on a 10-point scale, with 1 being the least improvement and 10 being the most improvement.

The average score that the participants ranked their improvement in symptoms was a 5 out of 10.

So yes, the injection helped, but only slightly.

The Bottom Line: Corticosteroid injections can be helpful for short-term knee pain relief leading up to a long-term solution treatment such as surgery or genicular artery embolization. However, these injections are not without their own set of side effects and risks.

In our next article, we will take a look at the use and efficacy of hyaluronic acid injections. As well as dive deeper into what the research says about these temporary solutions to osteoarthritis knee pain.

Categories
Enlarged Prostate

Treating BPH with Prostate Artery Embolization

From minimally invasive to more extensive surgeries, there are several procedures that can treat benign prostate hyperplasia.

From minimally invasive to more extensive surgeries, there are several procedures that can treat benign prostate hyperplasia.

In recent years many men suffering from the uncomfortable and disruptive symptoms of an enlarged prostate, have been finding relief through a non-invasive procedure called Prostate Artery Embolization.

Prostate Artery Embolization is a procedure performed here at MidAtlantic Vascular and Interventional by our Interventional Radiologist.

The procedure begins with a small incision in the wrist or groin, followed by the insertion of a tiny catheter.

Using advanced X-Ray technology, the doctor will then guide the catheter through the blood vessels until it reaches the arteries that are feeding blood to the prostate gland.

Once the catheter has reached the proper location, it releases tiny microscopic beads. These beads then travel to the prostatic arteries, where they create a blockage, which blocks the blood flow that is causing the prostate gland’s enlargement.

Maybe this sounds a little like science fiction, or even too good to be true- but rest assured, it’s not.

Though Prostate Artery Embolization is a relatively new outpatient procedure, it’s nothing to be afraid of.

In fact, PAE has one of the highest rates of success. Not only do over 90% of men treated with PAE experience relief from their symptoms in the first year, but relief can continue on for years after that.

This means relief from BPH symptoms like:

  • Dribbling when you finish
  • A hard time getting started
  • A weak stream or you pee in stops and starts
  • Feeling like you still have to pee even after you just went
  • Having to go too often — eight or more times a day
  • Incontinence (when you don’t have control over when you pee)
  • An urgent need to pee, all of a sudden
  • You wake up several times a night to pee
  • Urinary tract infections, bleeding, bladder damage, and bladder stones

It is estimated that about 8 out of 10 men will eventually experience some or all of the above symptoms caused by an enlarged prostate.

Unfortunately, it is also estimated that only around 30% will actually seek medical treatment for BPH. This is highly problematic, especially for men over 40 because although BPH is quite common and usually not life-threatening, if left untreated it can get worse.

Untreated BPH can cause a slew of health problems such as frequent urinary tract infections, bleeding, bladder stones, and potential bladder and/or kidney damage.

The good news is, you can avoid experiencing these more severe issues that can come from untreated BPH by making an appointment with your doctor, or calling us here at MidAtlantic Vascular and Interventional.

Together, we can determine the right course of action, which could be taking medicine, PAE, making lifestyle changes, or a combination of these.

Treatment is available, so please call us and set up a consultation today.

Categories
Fibroids

Medical Advancements in Fibroid Treatment

MidAtlantic Vascular and Interventional, we specialize in the removable of uterine fibroids, through an advanced medical procedure.

Fortunately for the estimated 26 million women in the United States that have uterine fibroids, huge medical advancements have been made that allow for a variety of treatment methods. These range from medication to hormone therapy, as well as both invasive and non-invasive surgical procedures to remove the fibroids completely.

Here at MidAtlantic Vascular and Interventional, we specialize in the removable of uterine fibroids, through an advanced medical procedure called Uterine Fibroid Embolization.

Unlike medications, which primarily treat the symptoms of fibroids, Uterine Fibroid Embolization, focuses on treating the condition by removing the fibroids themselves.

So what is Uterine Fibroid Embolization? And how does it work?

Good question and we are happy to answer that. But first, let’s take a quick look at what a uterine fibroid is.

Uterine fibroids are noncancerous growths of the uterus that often appear during a woman’s childbearing years. These growths are made of smooth muscle cells and fibrous connective tissue. Sometimes fibroids are solitary, but it is also common to have multiple ones.

Uterine fibroids range in size. Some are so tiny that they are undetectable by the human eye alone. While others can be large enough to distort and enlarge the uterus.

How can I tell if I have a fibroid?

When a woman has a fibroid, it is most often discovered during a routine pelvic exam or imaging procedures performed for other reasons. If the fibroid or fibroids do not cause any symptoms, pain, or discomfort, and are not affecting fertility- then they usually do not require treatment. However, when symptoms are present, these can be managed with medications, surgery, and by using minimally invasive techniques.

Some of the symptoms associated with fibroids are:

• Unusually heavy period
• Long than normal periods
• Bleeding in between periods
• Pressure and pain in the pelvis
• Frequent urination
• Lower back pain
• Pain during intercourse
• Difficulty conceiving

Ok, so back to the original question: What is Uterine Fibroid Embolization?

Uterine Fibroid Embolization is a non-invasive procedure to remove uterine fibroids. Rather than requiring general anesthesia, the procedure uses conscious sedation ( an IV of a light sedative) to help you to relax and remain pain-free during the UFE procedure.

Once the sedating medicine has been administered, our expert radiologist will begin the procedure.

The UFE procedure commences with our expert Interventional Radiologist, Dr. Rishi Sood, making a teeny tiny nick in the skin (about the size of the tip of a pencil). He will then thread a tiny 2mm catheter through the groin or wrist. Using moving X-ray technology (fluoroscopy), Dr. Rishi will then guide the catheter through the blood vessels until it reaches the artery that supplies blood to the fibroids.

Once the catheter reaches the artery that supplies blood to the fibroids, tiny gelatin beads are released through it, which travel into the artery, creating a blockage. This blockage cuts off the blood supply to the fibroids. And, without the fibroids being able to receive vital nutrients through the blood, they can not survive.

A blockage? Isn’t that dangerous?

No, in this case, it is not. Unlike a blockage to the heart or other vital organs, this particular blockage is only cutting off the blood supply to the fibroid. The results are remarkable, for, without the fibroids being able to receive vital nutrients through the blood, they shrink until they are altogether eliminated.

Does this sound too good to be true?

Maybe, but rest assured it is not. In fact, according to the New England Journal of Medicine, the success rate of uterine fibroid embolization is estimated to be upwards of 95%.

This is great news to the millions of women that are suffering from the pain and discomfort that comes with having uterine fibroids.

In our next article, we will take a look at what you can expect during the UFE procedure. What does it feel like? How long does it take? And what does the recovery period look like?

In the meantime, for more information on Uterine Fibroid Embolization, or to make an appointment for your consultation, please reach out to us at 301-622-5360.

Categories
Knee Osteoarthritis

Prescription Painkillers for Knee Pain

The first line of medication treatment to reduce knee pain is usually NSAIDs, however, sometimes opioids are used. But are they worth their risk?

The first line of medication treatment to reduce knee pain is usually NSAIDs, however, sometimes opioids are used. But are they worth their risk?

As we covered in previous articles, NSAIDs stand for Nonsteroidal anti-inflammatory drugs and are used to treat inflammation, pain, and swelling. These medicines can be bought at the drugstore, grocery store, and even at one of your local gas stations.

They are common, they are everywhere, and they are helpful.

However, though NSAIDs are effective, they can be problematic when taken for long periods of time or at high doses. Higher doses and time spent taking these medications can increase the risk of gastrointestinal bleeding, and ulcers, and even lend themselves to cardiovascular problems. NSAIDs can also cause fluid retention and kidney problems.

For people with knee osteoarthritis who can not achieve adequate pain relief from over-the-counter medicines, or can not take them for other reasons, sometimes the prescription drug tramadol is used.

Tramadol, which is sold under the brand names Ultram®, Ultracet, and Ultram® ER (extended-release), among others, is an opioid pain medicine that is sometimes used to treat moderate to moderately severe pain. Belonging to a class of opiate analgesics, tramadol is a narcotic that works by changing the way the brain and the nervous system respond to pain.

When it comes to relieving acute pain, prescription painkillers are sometimes used because they can relieve acute pain very effectively. The most common of these are morphine, codeine, and oxycodone, among several others- and they are primarily used in emergency and intensive care situations to induce anesthesia or reduce severe pain.

Though prescription painkillers like tramadol are sometimes used to treat osteoarthritis knee pain, recent studies have shown evidence that they don’t necessarily work better than NSAIDs do. Not only that but opioids like tramadol have been shown to lose their effectiveness with time.

Recently, The Cochrane Review shared the results of some extensive research regarding the benefits and harms of tramadol for treating osteoarthritis. They examined 22 studies involving 3871 people taking tramadol and 2625 people in a comparator group.

What they found overall, was that compared with a placebo, the evidence showed that taking tramadol for up to three months had no important benefit on pain or function. They also found that many people in the tramadol group experienced side effects that led them to stop taking it, such as nausea, vomiting, dizziness, constipation, tiredness, and headache.

Other studies have found that tramadol can be effective at relieving osteoarthritis pain in elderly sufferers, but, only when it is combined with acetaminophen ( Tylenol).

This makes one wonder if it’s the tramadol or the Tylenol that’s making the difference. In fact, a recent meta-analysis comparing NSAIDs and opioids for relief of knee osteoarthritis pain in over 5,500 patients found that on average, oral NSAIDs, less potent oral opioids (such as tramadol), and more potent oral opioids (such as oxycodone) all had similar efficacy and each reduced pain by about 30 percent.

There are also some studies that present evidence to support the claim that using opioids, such as tramadol to relieve osteoarthritis pain can actually make the condition worse. The problem is believed to be caused by the fact that opioids alter the perception of pain, but they do not do anything to help improve the symptoms of osteoarthritis.

Unlike NSAIDs, Tramadol doesn’t reduce inflammation and swelling, and it comes with its own set of side effects, ranging from nausea, vomiting, and dizziness, to addiction and even death.

Fortunately, most people do not need to take opioids for knee osteoarthritis, and most doctors will err on the side of caution when it comes to prescribing them. Though opioids, like tramadol, can be helpful in the short-term treatment of severe pain, in order to bridge the gap until a knee surgery or procedure can be performed- other than that, most find they are better off using NSAIDs for pain relief.

For those that wish to avoid taking medications as much as possible or who wish to focus on treating knee osteoarthritis directly, there are many other options. Not only can physical therapy and diet and lifestyle changes make a difference, but so can an invasive surgery such as a knee replacement, or a non-invasive procedure called Genticular Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: Sometimes due to an inability to take NSAIDs due to gastrointestinal problems, cardiovascular risks, and kidney problems, a prescription opioid such as tramadol could be prescribed. However, even in these cases, the risks and potential problems that can come from using opioids may outweigh the benefits.

Categories
Enlarged Prostate

An Enlarged Prostate: Signs and Symptoms

Getting up several times to urinate throughout the night, could be a symptom of benign prostate hyperplasia.

Getting up several times to urinate throughout the night, could be a symptom of benign prostate hyperplasia. Which is also known as an enlarged prostate.

An enlarged prostate? What does that mean?

Well, before we get into that, let’s take a look at exactly what the prostate is.

The prostate is a small gland that is part of the male reproductive system.

It is responsible for aiding in the production of fluid that carries sperm from the testicles and helps to push semen through the urethra during ejaculation.

The prostate is located below the bladder, in front of the rectum,  and surrounds part of the urethra.

Typically the prostate is about the size and shape of a walnut, however, as a man ages, the prostate can become larger.

Though it is normal for the prostate to grow, sometimes this growth can be problematic and become Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate.

BPH occurs when the prostate grows large enough that it begins to pinch the urethra, causing troubling symptoms such as:

  • a weak flow when you urinate
  • a feeling that your bladder hasn’t emptied properly
  • difficulty starting to urinate
  • dribbling urine after you finish urinating
  • needing to urinate more often, especially at night
  • a sudden urge to urinate

The prostate’s squeezing of the urethra also causes the bladder to have to work even harder to pass urine. This over time, can cause the bladder muscles to become weak, making it harder for it to be emptied. This can also lead to:

  • Feeling like you still have to pee even after you just went
  • Having to go too often — eight or more times a day
  • Incontinence (when you don’t have control over when you pee)
  • An urgent need to pee, all of a sudden
  • You wake up several times a night to pee
  • Urinary tract infections, bleeding, bladder damage, and bladder stones

If you are experiencing any of these symptoms, you may be dealing with the effects of an enlarged prostate and, you are not alone.

The urinary issues related to prostate size are so common, that on average about 8 out of 10 men will eventually experience it.

Though men with an enlarged prostate might not experience every one of the symptoms listed above, and the severity may vary, it’s still important to make an appointment with your doctor to identify or rule out any underlying causes.

If left untreated, urinary problems, especially those caused by an enlarged prostate, could lead to more serious problems such as frequent UTIs, an obstruction of the urinary tract, and serious bladder or kidney damage.

If you are experiencing the symptoms of an enlarged prostate, it’s important to schedule a visit with your doctor.

If treatment is necessary, your doctor will work with you to find the best treatment for you. This could mean taking prescribed medication, or it could mean making some lifestyle changes to help control BPH symptoms.

If the symptoms are particularly bothersome, your doctor may recommend that the prostate be treated directly through surgery or a non-invasive procedure such as Prostatic Artery Embolization– which we specialize in here at MidAtlantic Vascular and Interventional.

In the meantime, if you’d like to learn more about Prostate Artery Embolization, or schedule a visit to find out if this treatment could benefit you, please do not hesitate to call us at 301-622-5360 to set up a consultation.

Categories
Fibroids

Recovery Time of Fibroid Treatment

When it comes to the different procedures that can remove uterine fibroids, the recovery time of each method is something to keep in mind.

When it comes to the different procedures that can remove uterine fibroids, the recovery time of each method is something to keep in mind.

Some surgeries like a hysterectomy will require a few nights of hospitalization following the procedure, and take several weeks or even months of rest in order to fully recover.

Other fibroid removal procedures like Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional, can be performed as an outpatient procedure, allowing for the patient to go home the same day. Not only that, but most women find they can resume their normal activities in a few days.

Really?

Yes! The average recovery period from Uterine Fibroid Embolization is about 1-2 weeks!

Though UFE is a ground-breaking non-invasive treatment that is efficient, effective, and has a much shorter recovery period- some women are still opting to have their fibroids removed through the surgical procedures of a hysterectomy or a myomectomy. The reason for this, in some cases, is that many women are unaware of the other options available, and therefore are still opting to have a more invasive procedure. Therefore a myomectomy still remains one of the most common treatment methods for removing fibroids.

As we’ve covered in previous articles about the surgical removal of fibroids, a myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact and is a treatment option for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons.

There are three main types of myomectomies: laparoscopic myomectomy, abdominal myomectomy, and hysteroscopic myomectomy.

Today let’s take a look at the expected length of recovery following each type of myomectomy.

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

1. Laparotomy, also known as an Abdominal Myomectomy:

A laparotomic myomectomy is performed as open surgery, by way of an abdominal incision.

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, which are fibroids that are located primarily within the width of the uterus.

Recovery Period:

Though effective, due to its invasiveness, a laparotomic myomectomy has a higher risk for blood loss and scarring and involves the longest recovery period among the different types of myomectomies.

An abdominal myomectomy is usually followed by a 2-3 day hospital stay. Once back at home, the average post-surgical recovery period is around 6 weeks, which includes avoiding exercises, such as biking, jogging, and aerobic exercise. It also requires complete abstinence from lifting anything that could cause strain on the body.

During the recovery period, most women will need to take at least 2-3 weeks off from work so that they can rest and recover, depending on the type of work that they do and how they feel during the weeks following the procedure.

2. Laparoscopy:

During a laparoscopic myomectomy, the surgeon will make four incisions of about a half-inch each into the lower abdomen. Through these, a laparoscope and other small instruments are inserted into the uterus to remove uterine fibroids.

A laparoscopic myomectomy is most appropriate for fibroids located on the outer layer of the uterus, known as the serosa. Known as subserosal fibroids, this particular type of fibroid grows toward the outside of the uterus. And, similar to an abdominal myomectomy this method of fibroid removal requires general anesthesia.

Recovery Period:

Though a laparoscopic myomectomy is less invasive than an abdominal myomectomy, the amount of time it takes to recover post-op is still significant.

A laparoscopic myomectomy operation is usually followed by at least one night in the hospital. After that, the general restrictions are the same as those after an abdominal myomectomy, however, most women find they can resume some normal activities within about 4 weeks.

3. Hysteroscopy:

During a hysteroscopic myomectomy, fibroids are removed using a surgical instrument called a hysteroscopic resectoscope which is inserted through the vagina and cervix and into the uterus. Then, a wire loop is used to shave off and thereby remove the fibroids.

A hysteroscopic myomectomy is typically the most appropriate type of myomectomy for fibroids that bulge into the uterus, called submucosal fibroids.

Recovery Period:

A hysteroscopic myomectomy involves general or local anesthesia and most women are able to go home the same day as the procedure, following a few hours of observation. However, in rare cases, a night of recovery in the hospital can be necessary.

The Bottom Line:

A hysterectomy and any type of myomectomy procedure to remove uterine fibroids will result in a longer period of post-op recovery, especially when compared to a non-invasive procedure like Uterine Fibroid Embolization.

In some cases, the recovery may take a few weeks, in other cases, it could take months. In fact, some women might experience less post-surgery pain than others, while some may need to take prescription pain relievers and limit their activities for quite some time. However, regardless of the rate of recovery, all women will experience a period of recovery and will need to take certain precautions and adhere to the restrictions set forth by their doctor, to have the safest, shortest, recovery period possible.

In our next article, we will take a look at the recovery time of the fibroid removal procedure, Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

Unlike a myomectomy, UFE addresses and eliminates all types of uterine fibroids, allowing for a fully functional uterus post-surgery, without risks and complications from fibroid surgery. UFE has a recovery time of about a week allowing a woman to quickly return to their normal daily life.

To learn more about UFE and to set up a consultation, please call us today.

 

Categories
Knee Osteoarthritis

Frequent use of NSAIDs: Is it Worth the Risk?

In the United States, it is estimated that over 29 million people use over-the-counter pain medication such as aspirin or ibuprofen daily.

In the United States, it is estimated that over 29 million people use over-the-counter pain medication such as aspirin or ibuprofen daily.

You read that right.

29 million people are popping over-the-counter pain pills every day, for everything from back pain to joint pain, to knee osteoarthritis pain.

NSAIDs, which stands for non-steroidal anti-inflammatory drugs, are so widely used that they can be found everywhere from drugstores to supermarkets, airports, gas stations, and even in vending machines.

The most commonly used NSAIDs in the United States are:

  • Aspirin (available as a single ingredient known by various brand names such as Bayer® or St. Joseph® or combined with other ingredients known by brand names such as Anacin®, Ascriptin®, Bufferin®, or Excedrin®).
  • Ibuprofen (known by brand names such as Motrin® and Advil®).
  • Naproxen sodium (known by the brand name Aleve®).

Acetaminophen (Tylenol®) is sometimes mistakenly referred to as an NSAID, but it’s not. Though it is also a pain reliever and fever reducer, acetaminophen doesn’t have the anti-inflammatory properties of NSAIDs. However, acetaminophen is sometimes combined with aspirin in over-the-counter products, such as some varieties of Excedrin®.

Whether it’s NSAIDs or acetaminophen, the bottom line is that millions of Americans rely on these medications every day, to reduce aches and pains, inflammation, and joint pain, which brings in billions of dollars every year.

Consumer reports published the results of their research on the most popular over-the-counter pain medications, and the amount of money the sale of them brought in, in millions of US dollars, in 2019.

This is what they found:

Though these medications can be effective at reducing knee pain related to osteoarthritis, when used long-term, they can cause more harm than good.

In fact, the recommendation by the makers of these drugs is that they shouldn’t be used continuously for more than three days for fever, and 10 days for pain, unless it is under the suggestion and care of a physician.

Based on your particular situation, if your doctor gives you the green light to take NSAIDs for a longer period of time, it’s important to make sure that they monitor you for any harmful side effects. In which case, the medicine will need to be stopped entirely, and a different type of pain medicine or treatment will need to be administered.

Some common side effects like bloating, increased gas, heartburn, stomach pain, nausea, and constipation can generally be prevented by taking an NSAID with food, milk, or an antacid. However, if these symptoms continue even when combined with food, milk, or an antacid, it’s important to inform your doctor so the medication can be stopped and changed.

A few other common side effects of NSAIDs include:

  • Dizziness.
  • Feeling lightheaded.
  • Problems with balance.
  • Difficulty concentrating.
  • Mild headaches.

If these symptoms go on for more than a few days, stop taking the NSAID and call your doctor.

Though most of the aforementioned symptoms are mild and can be treated with another medicine, by reducing the amount taken, or switching medicines, some side effects are serious and when experienced should be followed by a call to your doctor immediately.

These serious side effects include:

  • Gastrointestinal/urinary
  • Black stools — bloody or black, tarry stools.
  • Bloody or cloudy urine.
  • Severe stomach pain.
  • Blood or material that looks like coffee grounds in vomit (bleeding may occur without warning symptoms like pain).
  • Inability to pass urine, or change in how much urine is passed.
  • Unusual weight gain.
  • Jaundice.
  • Head (vision, hearing, etc.):
  • Blurred vision.
  • Ringing in the ears.
  • Photosensitivity (greater sensitivity to light).
  • Very bad headache.
  • Change in strength on one side is greater than the other, trouble speaking or thinking, change in balance.

It’s also important to watch out for possible allergic reactions and other problems such as:

  • Fluid retention (recognized by swelling of the mouth, face, lips, or tongue, around the ankles, feet, lower legs, hands, and possibly around the eyes).
  • Severe rash or hives or red, peeling skin.
  • Itching.
  • Unexplained bruising and bleeding.
  • Wheezing, trouble breathing, or unusual cough.
  • Chest pain, rapid heartbeat, palpitations.
  • Acute fatigue, flu-like symptoms.
  • Very bad back pain.
  • Feeling very tired and weak.

Due to the risks involved in taking medications, some would rather avoid them as much as possible. Fortunately,  medication is not the only option when it comes to reducing knee pain caused by osteoarthritis. Nor is major surgery, such as knee replacement surgery, and other invasive procedures with long recovery periods.

Though some patients benefit from all sorts of other treatments ranging from injecting medication called corticosteroids or hyaluronic acid which can be injected when knee pain becomes severe- many find great benefits from Genticular Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

To learn more about this state-of-the-art procedure to reduce knee pain and increase mobility, please call and set up a consultation with us today!

In our next article, we will look into the use of prescription painkillers that are sometimes used to treat osteoarthritis knee pain and the risks that come along with choosing these particular types of medication for pain relief.

 

Categories
Enlarged Prostate

BPH Medication: Combination Therapy

Evidence suggests that combining alpha-blockers and 5-alpha reductase inhibitors, is the most effective medication-based treatment for BPH.

Of all of the medication-based treatments for an enlarged prostate, there is evidence to suggest that combination therapy of alpha-blockers and 5-alpha reductase inhibitors, is the most effective.

Alpha-blockers are medicines that are used to relax muscle tissue thereby helping to relieve pressure and urinary symptoms associated with an enlarged prostate, such as tamsulosin (Flomax) or terazosin (Hytrin).

While 5-Alpha Reductase Inhibitors such as dutasteride (Avodart) and finasteride (Proscar), are medications that can shrink the prostate.

One study, in particular, found that the combination therapy of alpha-blockers and 5-alpha reductase inhibitors 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.

Using a combination of alpha-blockers and 5-alpha reductase inhibitors in the treatment of an enlarged prostate has shown promising results, however, it is not without its own set of side effects and risks.

According to a meta-analysis study published in the medical journal Aging Male, entitled “Impact of combination therapy 5-alpha reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: A systematic review with meta-analysis,” the overall prevalence of erectile dysfunction and reduced libido was found to be significantly greater for men treated with the combination therapy of alpha-blockers and 5-alpha reductase inhibitors.

In fact, they found that combination therapy not only increased the risk of erectile dysfunction significantly, compared to the prevalence of this side effect during monotherapy with just alpha blockers or 5-alpha inhibitors- but they also found that combination therapy resulted in more reported cases of reduced libido than monotherapy.

Other potential side effects of these medications are:

Dizziness, headache, and fatigue (most common)
Decrease in sex drive
Erectile dysfunction
Retrograde ejaculation
Decreased volume of ejaculate
Dry mouth, stuffy nose, and swelling of the ankles
Breast disorders (painful or enlarged breasts)
Low blood pressure

Both alpha-blockers and 5-alpha reductase inhibitors have their side effects, as well as their benefits.

The primary benefit of alpha-blockers is that they offer quick relief from BPH symptoms – usually in days to weeks. Whereas with 5-alpha reductase inhibitors, a benefit is that they can shrink the prostate and potentially avoid the need for prostate surgery, however, it can take anywhere from three to six months to experience any signs of improvement.

Even though combination therapy shows more promising results in the treatment of BPH, alpha-blockers are still the most commonly prescribed treatment. However, alpha-blockers are only effective in the short term, and symptoms will most likely return once the medication is stopped.

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.

In our next article, we will take a look at what the research says about the efficacy of Prostate Artery Embolization and compare it to the efficacy of medication therapy in the treatment of benign prostate hyperplasia.