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Tired of Running to the Bathroom? Reasons and Solutions for Men · Bryan Health Podcasts

• 0:03
  Melanie Cole, MS (Host): Welcome to Bryan Health Podcast.
• 0:05
  I'm Melanie Cole.
• 0:06
  We're here to talk about a common problem men have as they age.
• 0:11
  They need to urinate frequently, but then often feel like they can't go
• 0:16
  or have a weak stream or feel like they can't even empty their bladder.
• 0:20
  It could be caused by an enlarged prostate, and there is a
• 0:24
  non-surgical treatment for it called prostatic artery embolization.
• 0:29
  Joining me is Dr.
• 0:30
  Jack Burt.
• 0:31
  He's an interventional radiologist at Nebraska Vascular and Interventional.
• 0:36
  Dr.
• 0:36
  Burt, thank you so much for joining us today.
• 0:38
  I'd like to start by having you explain a little bit about the prostate itself.
• 0:43
  What happens to the prostate as men age?
• 0:47
  Dr. Jack Burt:
• 0:47
  Yeah.
• 0:47
  Thanks so much for having me, Melanie.
• 0:49
  Really looking forward to discussing this topic.
• 0:52
  So, I guess kind of the first question is what is the prostate?
• 0:55
  The prostate is a gland that's part of the male reproductive system, and it sits just
• 1:01
  beneath the bladder, and wraps around the urethra, which is the tube that carries
• 1:07
  urine out of the body from the bladder.
• 1:11
  So, that's the prostate.
• 1:13
  An enlarged prostate is an extremely common condition in aging men.
• 1:18
  it's called benign prostatic hyperplasia or BPH.
• 1:23
  In younger men, the prostate is normally the size of like a
• 1:27
  walnut, as men age, the prostate often continues to grow in size.
• 1:33
  As men reach their 40s and 50s, the prostate is usually about the size
• 1:38
  of a golf ball, and it can stay that same size throughout the rest of their
• 1:41
  life, or it can actually continue to grow and grow and sometimes get to
• 1:46
  the size of a baseball or a softball when they get to their 60s and beyond.
• 1:52
  So, the problem with that is because the urethra runs through the
• 1:55
  prostate, that growth of the prostate can slowly squeeze that urethra.
• 2:01
  It's almost like stepping on a garden hose.
• 2:04
  What is important for patients to understand, though, BPH
• 2:07
  is not prostate cancer.
• 2:08
  Now, prostate cancer can increase the size of your prostate.
• 2:11
  But BPH, it's a benign non-cancerous enlargement of the prostate.
• 2:16
  it can still significantly impact quality of life, though.
• 2:20
  Melanie Cole, MS: Well, that was a great explanation, Dr.
• 2:22
  Burt.
• 2:23
  You explained it all so well.
• 2:24
  So when the enlarged prostate presses on that urethra, it can affect
• 2:29
  bladder function and quality of life.
• 2:31
  And so, we're going to talk a little bit about those symptoms,
• 2:34
  those quality of life symptoms.
• 2:36
  So, tell us those symptoms.
• 2:37
  What happens as the prostate enlarges?
• 2:40
  What are men experiencing?
• 2:42
  Dr. Jack Burt:
• 2:42
  So, the most common symptoms of an enlarged prostate, it's urinary
• 2:47
  symptoms that slowly worsen over time.
• 2:50
  It typically starts in the 40s or 50s and just continues to get
• 2:52
  worse over time as males age.
• 2:55
  So most men with BPH, they'll describe waking up multiple times at night to
• 3:00
  urinate like three or more times, and that it's significantly impacting their sleep.
• 3:06
  They have to drink like six cups of coffee in the morning to not feel like
• 3:09
  a walking zombie throughout the day.
• 3:12
  Most men with BPH have a weak stream.
• 3:15
  They have difficulty getting started.
• 3:18
  They have to push to start and then frequently start and
• 3:21
  stop while they're urinating.
• 3:24
  Oftentimes they have sudden urges to urinate all of a sudden.
• 3:28
  And then, even after they get done, they feel like they really never
• 3:32
  completely empty their bladder.
• 3:35
  So, like I said, a lot of guys just think that this is kind of part of getting
• 3:39
  older and it can be a sensitive topic.
• 3:41
  They'll say something like, "Well, I figured it was just part of aging."
• 3:44
  And yeah, to an extent, it is a natural part.
• 3:47
  But it doesn't mean that you have to live with it, right?
• 3:50
  Especially since there are some really good treatments now available.
• 3:53
  Melanie Cole, MS: Well, thank you for saying that.
• 3:54
  So, tell us about some of the tools.
• 3:57
  there's so many tools, and we're talking today about PAE or
• 4:01
  prostatic artery embolization.
• 4:04
  Dr. Jack Burt:
• 4:04
  Yeah.
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  So, a newer tool in our toolbox to treat BPH is PAE.
• 4:10
  So PAE, what it stands for is prostate artery embolization.
• 4:15
  It's a modern and minimally invasive procedure, and it's performed
• 4:19
  by interventional radiologists, and it's used to treat BPH
• 4:23
  without the traditional surgery.
• 4:25
  So instead of going through the urethra to cut or burn away prostate
• 4:31
  tissue, we perform prostate artery embolization entirely through
• 4:37
  the blood vessels of the body.
• 4:39
  So, embolization is just a fancy word that means stopping blood flow.
• 4:45
  So, we're essentially stopping the blood flow to the prostate in this procedure.
• 4:50
  And it's an outpatient procedure typically done with light or moderate sedation.
• 4:55
  Melanie Cole, MS: Well, tell us about the benefits of this procedure and
• 4:59
  a little bit about the outcomes.
• 5:01
  What can men expect?
• 5:03
  Dr. Jack Burt:
• 5:03
  Benefits are really what's led to its rapid growth nationally
• 5:07
  over the last few years.
• 5:09
  Patients are attracted to this surgery because there's no big skin incision.
• 5:13
  It's not a major surgery.
• 5:15
  There's nothing going through the urethra, and they're not going home
• 5:19
  with a Foley catheter or anything through the urethra after the surgery.
• 5:23
  There's a lower risk of bleeding.
• 5:25
  It's a same-day outpatient procedure with very quick recovery, and there's
• 5:29
  actually lower risk of sexual side effects like, erectile dysfunction
• 5:33
  compared to some other surgical options.
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  So, most of our patients are back to normal activities
• 5:39
  within just a couple of days.
• 5:41
  It's really attractive for males that are on blood thinners or who might have
• 5:47
  a very large prostate that can sometimes make surgical treatment difficult.
• 5:52
  And in terms of the effectiveness and the success, multiple studies
• 5:56
  have now shown that the majority of our patients are significantly
• 6:00
  improving their urinary symptoms as well as their quality of life within
• 6:04
  just a few weeks after the procedure.
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  Symptom relief can last for many months, even five years and beyond.
• 6:11
  So, very similar to other therapies.
• 6:13
  So, with that said, proper patient selection is very important.
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  That's why we collaborate with our colleagues, the urologists.
• 6:21
  Melanie Cole, MS: Now, you mentioned patient selection.
• 6:23
  So if somebody wants to investigate this procedure, how would they know that
• 6:29
  they might be considered a candidate?
• 6:31
  Dr. Jack Burt:
• 6:31
  Basically, the first step is seeing us in clinic over here
• 6:35
  at Bryan Specialty Clinic.
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  We do a detailed history and physical.
• 6:39
  We review your symptoms and score your symptoms and any prior treatments
• 6:43
  or imaging that you may have had.
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  Many patients have already tried medications like Flomax or others,
• 6:50
  and sometimes they didn't tolerate it or simply didn't get enough relief.
• 6:55
  We also work with our urology colleagues to make sure there isn't
• 6:58
  any underlying issue contributing to the symptoms other than BPH.
• 7:02
  So, generally speaking, ideal candidates are men with bothersome
• 7:06
  urinary symptoms from BPH who want a minimally invasive treatment option.
• 7:11
  Melanie Cole, MS: Wow.
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  I mean, it really is amazing the technology.
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  It's such an exciting time in your field.
• 7:17
  Where do you see BPH treatment going?
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  What would you like to see happening?
• 7:22
  What's exciting in your field right now for men that are
• 7:26
  dealing with these symptoms?
• 7:29
  Dr. Jack Burt:
• 7:29
  One of the most exciting things about medicine in general is being
• 7:32
  able to offer patients effective treatments that are less invasive
• 7:38
  than they were 10 to 15 years ago.
• 7:41
  And I think PAE is a really good example of that.
• 7:44
  You know, for the right patient, it can dramatically improve their
• 7:48
  quality of life, and that's what we're here to do, is to empower a patient
• 7:53
  and improve their quality of life.
• 7:55
  Melanie Cole, MS: Well, thank you so much, Dr.
• 7:57
  Burt, for joining us and sharing your expertise to tell us about something that
• 8:02
  I think really men need to hear from you.
• 8:06
  They need to hear that this is not so scary, that this quality of life
• 8:10
  doesn't have to be this way, and that there are treatments available.
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  So, thank you so much for joining us.
• 8:17
  I'd also like to thank our Bryan Foundation partner, Pinnacle Bank.
• 8:21
  And to listen to more podcasts from our experts, you can
• 8:24
  visit bryanhealth.org/podcasts.
• 8:27
  And that wraps up this episode of Bryan Health Podcast.
• 8:30
  Please always remember to subscribe, rate, and review Bryan Health Podcast on Apple
• 8:36
  Podcasts, Spotify, iHeart, and Pandora.
• 8:39
  Until next time, I'm Melanie Cole.