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Ask Dr. Roach: Compressed abdominal arteries lead to aneurysm surgery | Lifestyle
Dear Dr. Cockroach: What is Celiac Artery Compression Syndrome? I am said to have this, and it is causing an aneurysm that needs to be repaired. I found it in a scan taken for another reason. I had a little pain after eating.
— IJM
Dear reader: The celiac artery is one of the three large arteries that supply blood to the abdominal organs, especially the stomach, part of the small intestine, liver, and spleen. The arteries can be compressed from the outside by a structure called the median arch ligament. When this happens, other blood vessels take over the work that the celiac arteries cannot do due to compression, but sometimes people may experience abdominal pain after eating due to low blood flow. People who are symptomatic of the compression of celiac disease benefit from opening the arteries. Usually, a stent is used to keep the artery open. The celiac arteries can also be occluded by intravascular atherosclerosis, cholesterol and calcium deposits.
Increased blood flow in other blood vessels can cause abnormal dilation called an aneurysm. Unfortunately, these aneurysms can rupture, a catastrophic event. Since the risk of repairing an aneurysm is much less than the risk of rupture, it is advisable to first repair the celiac artery compression and then treat the aneurysm with coil embolization. The coil creates blood clots around and within the aneurysm, protecting the weakened part of the vessel wall and reducing the risk of rupture.
Vascular surgeons usually perform this surgery intravascularly (via blood vessels) without the need to open a person’s abdomen.
Dear Dr. Cockroach: I had a radical prostatectomy over 10 years ago. After the surgery, I needed 10 radiation treatments. My incontinence doesn’t go away. I tried Kegel exercises, but it didn’t work. I use pads on a regular basis, and I also use Cunningham clamps. Unfortunately, there are still leaks. I need to change the pad 3-4 times a day. I’ve heard about a product called AMS800. I am 84 years old I don’t know how to solve this problem. It’s very frustrating.
— Anon.
Dear reader: Incontinence after surgery for prostate cancer is common and often improves about a year after surgery. Some men continue to have moderate or severe long-term symptoms. You have already tried several treatments: Pelvic floor (Kegel) exercise can help women as well as men, but if the nerves are more severely damaged, these may not be very useful. not. Cunningham clamps, which are external clamps that close the urethra of the penis, are usually effective, but many men find it uncomfortable. Condom catheters are a good solution for some men.
If other treatments are ineffective, surgical solutions are considered. There are several options, but one of the most effective and reliable treatments is the artificial urethral sphincter. The AMS800 is one brand name for these devices and is surgically placed. Over 90% of men report that they are happy with the device. Complications include infection and erosion of surrounding tissues, both of which occur with a probability of 5% or less.
Only urologists have the expertise to say if this is a potential treatment for you, but it is an effective treatment for many men with long-term incontinence who have not responded to other treatments. It’s a law.
Contact Dr. Roach [email protected]
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