Tag: MidAtlantic Vascular and Interventional

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Enlarged Prostate

Improving Prostate Treatment with Innovation

One of the turning points in the treatment of benign prostate hyperplasia was the invention of the irrigating cystoscope.

One of the turning points in the treatment of benign prostate hyperplasia was the invention of the irrigating cystoscope, and the many improvements made to it by Dr. Hampton Young, of Johns Hopkins University Hospital.

Following the development of the irrigated cystoscope and other critical tools, physicians continued to experiment with all sorts of other methods for treating an enlarged prostate. This included high-frequency currents to treat bladder tumors.

In roughly 1926, a physician by the name of Maximilian Stern introduced another innovative instrument to be used in prostatic procedures called the resectoscope.

A resectoscope is a tool that is inserted through the cystoscope sheath and has a tungsten wire loop on one end. Under direct vision by way of the cystoscope, Dr. Stern was able to cut slivers of prostate tissue with the loop, through which flowed an electrical cutting current.

Unlike cautery heat, these high-frequency currents did not penetrate and damage the surrounding tissue nearly as much. As a result, patients reported having fewer side effects and a lower risk of complications such as hemorrhage.

Though the electric current cut well, some physicians took issue with it not coagulating deep enough. Thus making it, in some cases, just as effective as using a knife.

This led to the invention of a modified resectoscope by a South Carolina urologist, with a background in electrical engineering, named Theodore Davis.

Not only did Davis use a larger instrument with a larger viewing window and a wider loop, but he also is credited with incorporating a current that cuts and coagulates. Davis even went so far as to invent a foot pedal, which allowed him to switch between the two during surgery.

Around the same time that Davis was improving the resectoscope, another doctor by the name of Joseph McCarthy was busy making further improvements.

Dr. McCarthy was able to successfully combine the improved resectoscope with the phonendoscope, which had a greatly improved viewing system.

By combining these two advancements, McCarthey created what would become known as the Stern-McCarthy resectoscope.

In our next article, we will take a look at the Stern-McCarthy resectoscope and its use in the treatment of an enlarged prostate, and also begin to look at the dominant treatment methods that emerged, some of which are still performed today.

 

Categories
Knee Osteoarthritis

Knee Pain, Even at Rest?

The pain of knee osteoarthritis can be felt not only during movement such as walking, but also during rest.

The pain of osteoarthritis in the knees can be felt when standing up, walking, or doing any other movement. Which makes sense.

However, did you know that many people with knee osteoarthritis experience pain even when they are at rest?

In order to decrease this pain, many turn to over-the-counter NSAIDs, prescription medications, knee injections, and physical therapy. Then if none of those work, the next step is usually knee replacement surgery, however, this is changing as more and more people are opting to treat their condition with Genicular Artery Embolization.

Genicular artery embolization is a procedure that can treat knee osteoarthritis by blocking the blood flow to the inflamed areas of the knee that are causing decreased mobility and pain.

The outpatient procedure is performed by way of a tiny catheter which is inserted into the blood vessels and then guided by a highly skilled interventional radiologist, to the artery that supplies blood to the areas of knee pain.

The interventional radiologist then releases microscopic spheres into the specific blood vessel (genicular artery) to block this flow.

As a result of this blockage, inflammation is greatly decreased and so is knee pain.

Unlike knee replacement surgery which requires recovery time in the hospital, patients who undergo GAE treatment can go home the same day.

In most cases, pain relief begins to occur within two weeks, as the inflammation in the knee joint is reduced, thereby relieving the knee pain associated with osteoarthritis.

In fact, according to a study published in The Journal of Vascular and Interventional Radiology, knee pain has been shown again and again to be significantly reduced as a result of genicular artery embolization- particularly for those dealing with moderate-to-severe knee pain.

This particular study found that its participants showed continued improvement in their knee osteoarthritis symptoms at one-month, three-months, and at their six-month checkups. Not only did their symptoms improve, but the MRI scans taken at this point of recovery, proved it.

The Journal of Vascular and Interventional Radiology also published the results of a study that followed ten patients through their GAE journey, pre and post-procedure.

At the one-year mark, the participants reported:

Median pain: 15.4% improvement
Knee/leg function: 21.3% improvement
Quality of life: 100% improvement

This study also conducted follow-up tests with the participants that included a six-minute walk and a 30-second chair sitting/standing test. As a result of the GAE procedure scores for these tests improved by 26% and 43% respectively.

Add to that, the fact that in both studies no adverse reactions were reported, and you have yourself an excellent option for treating knee osteoarthritis.

To learn more about GAE, and to see if this procedure could benefit you and relieve your osteoarthritis knee pain, please call and set up a consultation today.

Categories
Fibroids

Excessive Cramping and Pelvic Discomfort

One of the most common symptoms associated with uterine fibroids is excessive cramping and pelvic discomfort.

One of the most common symptoms associated with uterine fibroids is excessive cramping and pelvic discomfort.

Unlike menstrual cramps, which are caused by the contracting uterus as it pushes out the endometrium during a monthly period, fibroid cramps can exist outside of the average 5-7 days that menstruation lasts.

In fact, for women with uterine fibroids, not only do these cramps occur outside of the menstruation period, but they can be rather severe. And, unfortunately, if the fibroids are left untreated, these symptoms are likely to get worse and include several others as well.

Fibroids can range in size and location. They also vary in terms of how many each woman has. Some women may have a single fibroid while others could have multiple fibroids.

When it comes to the symptoms directly related to uterine fibroids- the location, size, and number of fibroids can play a role in the specific symptoms experienced and their severity.

For example, women with large fibroids have reported that they feel a heaviness or pressure in their lower abdomen or pelvis. Not only is this uncomfortable, but it can also make it hard to lie down, bend over, or exercise.

Though all fibroids can contribute to pelvic pain and cramping, more often than not, these symptoms are experienced as a result of having intramural fibroids.

Intramural fibroids grow inside the muscular wall of the uterus. As intramural fibroids grow larger, they increase the likelihood of more severe symptoms that can have a direct impact on one’s quality of life.

The other types of fibroids can also cause cramping and pelvic discomfort. These types are called: submucosal, subserosal, and pedunculated fibroids.

Submucosal fibroids grow into the uterine cavity, while subserosal fibroids grow toward the outside of the uterus. Pedunculated fibroids are those that are not directly attached to the uterus and grow from a stem-like stalk.

Cramping and discomfort caused by submucosal fibroids are usually caused by the uterus trying to rid itself of them.

Unlike the contractions that happen every month in order to shed the endometrium, painful contractions caused by submucosal fibroids can happen at any time during a menstrual cycle.

No matter what type of fibroid is causing your uncomfortable symptoms- there is treatment available.

If you think you are experiencing moderate to severe cramping outside of your monthly period, or even if it’s severe during your period- it’s important to seek out treatment right away.

Though most causes of pelvic pain and cramping are treatable, if you do not address the issue it is likely that your symptoms and the underlying condition will get worse.

If the cause of the cramping is indeed fibroids, there are many treatment options available such as medication, surgery, or uterine fibroid embolization.

UFE is a non-invasive outpatient procedure that can relieve the painful cramping and other frustrating symptoms caused by uterine fibroids.

To learn more about UFE and to find out if it could benefit you, please call our office today.

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
Enlarged Prostate

Prostate Artery Embolization: What the Research Says

In our last article, we took a look at a non-invasive outpatient procedure to treat an enlarged prostate called Prostate Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Today let’s take a look at what some of the research says about the efficacy of this procedure. 

A recent study published in the medical journal Interventional Radiology looked at 1,000 men treated with Prostate Artery Embolization between 2006 and 2017. The particpants of the study were followed up with for several years after the procedure, where they were evaluated for enlarged prostate symptoms. Specifically, the researchers measured the size of the prostate and evaluated the partipants regarding erectile dysfunction, and urinary issues.

Given that one of the primary symptoms of an enlarged prostate is its impact on urination, the study involved measuring not only the amount of urine retained in the bladder after urination, but researchers also measured the urinary flow rate.

Lastly, each participant’s prostate-specific antigen levels ( PSA) were checked, which is a test that is used to screen for prostate cancer.

Now the big question- What did they find?

The data from these measurements found that at the short-term mark, the Prostate Artery Embolization treatment had a cumulative success rate (measuring all of the variables listed above), of over 90%.

The cumulative success rate of the Prostate Artery Embolization treatment was then measured at the 3-year mark, at which point the researchers found there was an 82% success rate, and again every year after that, resulting in a cumulateive long term success rate of 79%.

The study also discovered that, unlike medication and surgeries which can have unwanted sexual side effects, men treated with Prostate Artery Embolization did not report any adverse effects on their sexual function.

This is just one of the research studies conducted on the effect of Prostate Artery Embolization on men experiencing adverse symptoms from an enlarged prostate. However, there are many more out there, and they all tell us one thing: Prostate Artery Embolization is an excellent option for men with BPH, because it works.

Here at MidAtlantic Vascular and Interventional, we are proud to offer Prostate Artery Embolization and would love to schedule a consultation to see if this procedure can benefit you. That being said, PAE is one of many treatment options that are available for an enlarged prostate, so it’s important to speak with your doctor to determine which treatment is best for your particular case.

In our next article, we will take a look at some of the other treatment options available, starting with medications that are used to treat an enlarged prostate. We will look at the pros and cons of each treatment, to help you to be as informed as possible when making these important decisions for your health.

Categories
Enlarged Prostate

Prostate Artery Embolization for an Enlarged Prostate

Here at MidAtlantic Vascular and Interventional, we are proud to offer a non-invasive state-of-the-art treatment for men that are experiencing symptoms due to an enlarged prostate. The treatment is Prostate Artery Embolization, and it is an outpatient procedure that has over a 90% success rate for patients with a symptomatic enlarged prostate.

Though it is normal for the prostate to continue to grow as a man ages, for some it can develop into Benign Prostatic Hyperplasia (BPH). BPH, also known as an enlarged prostate, occurs when the prostate grows large enough that it begins to pinch the urethra, causing troubling symptoms that affect the ability to urinate, such as:

  • Dribbling when you finish
  • A hard time getting started
  • A weak stream or you pee in stops and starts

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 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

Fortunately, many patients are finding relief from these symptoms through the work of our Interventional Radiologist Dr. Rishi R. Sood, who is an expert in performing Prostate Artery Embolization.

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.

In our next article, we will take a look at some of the research backing the use of Prostate Artery Embolization as an effective treatment for BPH. In the meantime, please feel free to call us with any questions about PAE, or to set up a consultation to see if PAE is right for you.