New procedures for Veterans suffering from enlarged prostate

Avoiding the sexual and other side effects


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Vietnam Veteran Phil Gonzalez planned his life around his proximity to a rest room. The 69-year-old lived with the fear of not making it to the toilet in time. His sleep was restless as he got up numerous times throughout the night to use the restroom.

Gonzalez, like millions of men over 50, suffered from lower urinary tract infection symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). This condition is commonly referred to as an enlarged prostate.

Two new procedures at VA Salt Lake City Health Care System are giving Veterans who suffer from LUTS new hope.

Most male Veterans will need to see a urologist at some point in their life, according to Dr. William Brant, Urologist at VA Salt Lake City (pictured above). Forty million men in the United States have an enlarged prostate. In addition, more than 40% of men over 50 and 80% of men over 70 experience symptoms.

Symptoms a lot of men will recognize

Symptoms can range from irritating to obstructive to dangerous. For example, on the irritating side, men experience frequent urination and a strong urgency to urinate. They also get up multiple times at night and sometimes experience burning or pain when urinating. Veterans experiencing obstructive symptoms have trouble initiating stream, pushing to urinate and weak stream.
They feel they have not completely emptied or are unable to empty their bladder. As a result, they feel the need to go back to the restroom and finish the job.

If not treated, men can experience a deterioration of overall bladder health. The bladder may just stop working. This could lead to catheter dependency, urinary incontinence, bladder stones and urinary tract infections.

Surgery and medications can have sexual side effects

Gonzalez’s symptoms were irritating, but LUTS was still affecting his quality of life. He wanted to change that.

In the past, treating LUTS would mean potentially taking medication for the rest of your life or surgery. Both have numerous side-effects and drawbacks for Veterans. Men often stop taking the medication or only take it periodically, not as recommended by their doctor.

Surgery can have complications and can include hospital stays. Both surgery and medication can have sexual side effects.

VA Salt Lake’s urology staff started looking for alternatives

“What we were originally looking for was something that would give us the best chance of being able to treat all comers. That can be done in clinic and comfortably. And give good results without the side effects,” said Brant.

They found a solution in two new procedures: UroLift and Rezum.

“What’s nice about both of these is they really avoid the side effects. Particularly the sexual side effects. And they are a onetime deal,” said Brant.

Both UroLift and Rezum are in-clinic procedures. The procedures are fast and the patient is awake for the entirety. Doctors give some patients local anesthesia for minor pain and mild medication for anxiety.

What the procedures do

UroLift uses small implants to lift and hold prostate tissue out of the way of the urinary tract. It works almost immediately after procedure.

Rezum uses steam to kill prostate cells. The body naturally removes the dead cells, shrinking the prostate and opening the urinary tract. Patients start to see the effects within a few weeks, and see peak effect about six months after the procedure. The shape of a man’s prostate dictates the method a doctor will use.

Sleeping through the night

Gonzalez received the Rezum treatment. He now sleeps through the night and can sit through a church service without heading to the restroom. He no longer plans his day around locating the nearest restroom.

“When I have something to drink,” said Gonzalez, “I no longer have to hurry home or to the hospital. I think it’s great. It’s made me so happy.”

If you are Veteran suffering from an enlarged prostate, contact your VA urologist to find out if either of these two new procedures are appropriate for you.


Bruce Sperry is a surgical physician assistant. Jeremy M. Laird is a public affairs specialist. Both work at the Salt Lake City VA Medical Center.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Richard Fox    

    No major problems now but would like know more about these new options. Where, are we teaching to other, when will they be available Thru the Va system, can we be prescribed to go Tennessee?

  2. Arthur reddy    

    My psa went from 3.2 to 7.9 in one year. Has anyone experienced an incorrect blood test report

  3. Johnnie Carlisle    

    Everything sound’s great ,I would like to try this procedure

  4. CHARLES WEINACKER    

    73 year old Combat Viet Vet
    Too late…VA PCola Fl…would not address enlarged prostate..not service related.
    So I went to local urologist…prescribed palmetto…useless!
    Then one morning got up to piss…SOLID BLOOD! Once admitted to emergency…top urologist…diagnosed enlarged prostate/no shit…that got so large, busted vein/blood origin.
    Bottom line…removed half of my prostate…took 3 months to get urinary track muscle under control. Now I piss like a 16 year old…no more pain…no more dribble Happy Patient!!!. Still have erection/climax…but no more semen…who needs kids at 73…my guess was Mother poured too much Johnson Baby Powder down my pants. Have sent 6 buddies with prostate trouble to same urologist/Fairhope, Al…all buddies satisfied with same procedure!!!

  5. Pete Williams    

    Are only certain locations doing this and how do I request to be marked for this at my local Nashville TN location?

    1. Bill Hass    

      Is this available at the VA hospital in Mountain Home Johnson City TN ?

  6. William Crowell    

    Right now beginning my radiation treatments have been delayed due to corona virus. I use VA Louis Stokes Hospital in Cleveland, Ohio. How do I try for the new procedures? Does this procedure eliminate when you have cancer in the prostate? Thanking all for anticipated response.

  7. Richard Harri Schiltz    

    I have BPH. Incontinence and I’m 73. I’ve had two procedures with Botox shots to shrink my bladder in a VA Hospital. Worked for awhile then I had to use a 14″ catheter. Not very comfortable ! I
    I quit using the catheters, but still have a urinal bottle by my bed. Yes, daytime can be trying, going out, ok where’s the nearest bathroom? No I don’t want to sit in the middle row, halfway to the toilet on an airplane.
    How long have these two procedures been been around? How long were the trial periods and are or have there been any complications or side effects?

  8. John Licht    

    I am interested in learning more about the procures and available treatment.

  9. John Love    

    These procedures sound great! My question is (I have BPH and prostrate cancer) Can these procedures be used on me to relieve the swelling and side effects?
    For those who are against PSA tests and biopsies. Not every 4+ PSA needs a biopsy, however, a quickly rising PSA like mine was is a clear sign something is wrong. My PSA test started at 0.04 then went up about 1 point a year. When it reached 3.5 I asked my doctor about the quick constant rise and he said that anything under 4.0 is great. The following year it was 7.59 and the biopsy proved cancerous. BTW: I’d had all the symptoms of prostrate cancer for three or 4 years. I’ve had three biopsies including two with a contrast MRI before it to identify the size and position of the three tumors. I served in VN in 1967, ‘69 and the evacuation in’75 exactly 45 years ago ago. During my second tour I worked loading Agent Orange on the C-123’s. I expected to have P.C. as so many of my coworkers have had it. I demanded a PSA test ever year after I reached 55. Every Vietnam Nam vet should be tested yearly. You have the right to a PSA blood test with your annual blood test. DEMAND AN ANNUAL PSA TEST. It could save your life.

  10. David Webb    

    I suffer from enlarged prostate with a high PSA but no cancer detected. My urologist says the UroLift would not help me. I have the constant burning behind the scrotum. Would either of these work for me? I want to avoid prostate removal. Suggestions?

  11. Fred Russell Crowder    

    I would like to have the opportunity to have this done. I suffer from frequent trips to bathroom. At times, I have to ho 5’6 times in 1 or 2 hours.

  12. George C Atkinson Sr    

    Does the Rezum procedure help with ED as well as the BPH?

  13. George C Atkinson Sr    

    Does the Rezum procedure correct ED problems?

  14. Victor Sellers    

    I was hospitalized in Vietnam for a month, then medivac’d out. About eight months after Vietnam and still on active duty, I have documented evidence of a painful sensitive prostate. I have had prostate issues ever since Vietnam, but the VA has denied my claim for prostate pain and issues, and also intentionally withheld all my medical treatment records all my life after Vietnam, as well as denied all service connection up to 2015. I should have been medically retired with full pay and health care, so I should qualify. But, do I?

  15. James Broadway    

    I have a non-aggressive form of prostrate cancer and the present treatment is watchful waiting. Could I undergo either of these procedures?

  16. Joe Wheeler Moreland    

    I have had seeds implanted for prostrate cancer. Am I eligible for either of these procedures and which VA in NC could do this?

  17. Jack franklyn Burris    

    I had a urolift about 2 years ago at Samsung clinic because va did not offer procedure. I am 75 years old. I started to experience the urolift failing after 1 year. After 2 years I am back to square 1. Any ideas??

  18. Johnnie St.Clair    

    Does exposure from Agent Orange have any impact on early onset (late 40s) enlarged prostate? I was exposed in 1967 and in 2004 I had a TUMT, which lasted until 2019. In 2019 I had to undergo a TURP.
    Does this qualify me for VA disability?

  19. Kent L.S Gilmore    

    Thanks, keep us informed about changes in treatment and or changes due to Covid 19.

  20. Ronald Saylor    

    Very interested. Has this been rolled out across the U.S. and if not it may be worth a trip to Salt Lake City.

  21. NEAL STEITZER    

    I’m not taking anything away from the VA – I believe they are doing Great. However, if you have Medicare and Tricare, these procedures (not sure about Rezum) are covered by them. Find a good civilian Urologist who accepts Medicare and Tricare payments. I have been struggling with BPH for nearly 30 years. I’m 89. I’ve tried medication – no help; been through two microwave procedures (they were good for a few years); and then had the Urolift procedure (but was not in the 90% who benefit by it). I am now scheduled for a Urodynamic procedure (relates more for the bladder). Other than the BPH I am in pretty good health: 40 push ups, four miles in one hour. Hope you all can find relief.

  22. Daniel Cunningham    

    I suffer from the sexual side effects of a mis-diagnosed and mis-treated incontinence condition .
    That was at the VA in Phoenix.
    Learning about these new procedures gives me hope that the VA in SLC can possibly correct some of the damage that was done to me.
    I am looking forward to meeting the VA in Salt Lake to see what they can do for me.

  23. Michael A. Chargualaf    

    I am a veteran, and i am one of those 40% with enlarge prostate. What is/or the process that i need to start to get that treatment started.

  24. Courtney Haff    

    I wish to receive prostate treatment for enlarged prostate

  25. William C. Johnson    

    This procedure sounds promising, this condition causes many complication and the medication is a temporary daily fix My medication currently increases my urinary stream from the size of a cut piece of thin sewing thread to the width of a number two pencil and relieves bladder pressure. Surgery was mentioned as a future mandatory option for addressing long term issues.

    I am interested in this procedure if the result is a long term answer.

  26. Lawrence A Kozlowski    

    I understand there is a new test to detect prostrate cancer NOT relying on the PSA test that can be very inaccurate. After taking the PSA at my local VETS Clinic that turned out to be a “10” the doctor recommended me to a urologist. “SHE” wanted to do the old finger test and then if she thought it was needed to do a biopsy. Reading up on it I decided against it after hearing what the side effects of the biopsy might be. While searching I ran across a test they do at OPKO LAB in Nashville, Tennessee. I don’t fully understand it but it has something to do with “DIACETYL” and/or “PERFLUOROOCTANOIC ACID” or “PFOA”.
    Checking what the PSA might be I find anything up to a 6.5 is safe for men up to sixty-nine years old. Also, and this is something that I wasn’t told or made aware of, simple things like some vitamins or Advil or Aleve can give back incorrect results. I add that I had just received a second SHINGLES SHOT before my blood was taken. That being the case what should it be for me who is 74 years old AND WITHOUT ANY SIGNS OF A BAD PROSTRATE. Nobody can answer that question.
    It just seems the PSA is the quick an easy answer but a lot of men go through a lot of pain for nothing.

  27. William Detomaso    

    Don’t forget us Vietnam vets

  28. Steven Walker Poe    

    As a 73 year old Viet Nam vet I had lived with an enlarged prostate for over 15 years. I was treated by a really good urologist. Up to two months ago I was taking three medications (4 pills) per day one of which caused intermittent dizziness.

    Boring story short I selected the Rezum process. Out patient procedure with only oxycodone and some pretty strong Valium. I remember the entire procedure, and while embarrassing (three very nice ladies including the surgeon with me in gynecological stirrups) it was at worst slightly uncomfortable.

    The procedure was not done at a VA facility only because I had not been approved as a VA patient at that time. While not all clinics, hospitals and medical personnel are the same I would have no problem in having this procedure done by a practiced professional.

    My condition is 10% to 20% better than when I was taking medication and I still have a couple of months to go before the magic six month mark. It has easily been the right decision for me.

  29. William Detomaso    

    I have been diagnosed with BPH. I served in Vietnam 1969-1970 ,Danang. I recieved an environmental screening at the Syracuse VA and it was documented that I was exposed to Agent Orange. I avoid 4-5 times a night and at least every hour during the day. Semper Fi

  30. RAMIRO GARDEA    

    I would like to know more & if possible how to go about getting this procedure done. I live near the VA Hospital in Las Vegas, NV. Appreciate any information provided.

  31. Jeffrey Wansley    

    I currently have prostate cancer and am being treated with Ztiga chemo therapy. My PSA was 238 and now it’s below zero. Now what? I have been on Ztiga for almost two years.
    I am an outpatient at the VAMC in West Palm Beach, Florida.

  32. Richard A Vallejos    

    I have that issue with enlarged bladder and prostate. Please help me.

  33. John eatherly    

    Also would like to know where this procedural is available!!

  34. John eatherly    

    Sounds like this could be the answer , II am very interested in this process and how well it works. I am 71

    1. Gary Hinch    

      Are these procedures covered by the VA?

  35. Robert Berrett    

    What other VA facilities have the specialits to offer this treatment?
    Wahington, D.C., Boise, Idaho, Sarasota , Florida, San Francisco?

  36. Thomas Klenke    

    It the two new prostate procedures offered at the VA Hospital in Wichita Kansas. Since I’m over 40 miles can they be accomplished in a VA approved civilian hospital. I would really love to get back to my wife, if you get my drift. Thanks

  37. paul schultz    

    I only served 11 serves in the Navy. Am I eligible for this enlarged prostate treatment? If so, how do I apply?

  38. Daniel L Kibbee    

    More awesome stuff from VHA R&D people. Thank you.

Comments are closed.