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.