Aneurysm repair safer than rupture

Dear Dr. Roach: What is celiac artery compression syndrome? I’m told I have this, and it’s causing an aneurysm that needs to get repaired. I found out on a scan taken for another reason. I have had some pain after eating.

I.J.M.

Answer: The celiac artery is one of three large arteries that provide blood to the abdominal organs. The artery can be compressed from the outside by a structure called the median arcuate ligament. When this happens, other blood vessels take over the job the celiac artery can’t do because of the compression. The increased blood flow in the other blood vessels can occasionally cause abnormal dilatations, called aneurysms. Unfortunately, these aneurysms can rupture, which is a catastrophic event. The risk of fixing the aneurysm is much smaller than the risk of rupture, so it’s recommended to first fix the celiac compression, and then treat the aneurysm.

Dear Dr. Roach: I had a prostatectomy over 10 years ago. After the surgery, I required 10 sessions of radiation treatment. My incontinence is not going away. I tried Kegel exercises, but that didn’t help. I am using pads regularly, and also using Cunningham clamps.

Unfortunately, the leakage is still there. I have to change pads three or four times a day. I heard about the product called AMS800.

Anon.

Answer: Incontinence after prostate cancer surgery is common, and often improves in the year or so after surgery. Some men continue to have moderate or severe long-term symptoms. You have already tried some of the treatments. When no other treatments are effective, surgical solutions are considered. There are several options, but one of the most effective and reliable treatments is an artificial urinary sphincter. The AMS800 is a brand name of one of these devices, which is placed surgically. More than 90% of men report satisfaction with the device. Complications include infection, and erosion of the surrounding tissues, both of which happen 5% or less of the time.