A New York City urologist has seen more patients requesting a procedure that eases the urge to pee.
NYC's wealthiest are hoping to eliminate the need to go during the long drive to their summer homes.
Some are getting "bladder Botox" to avoid conflict over "Hamptons bladder" in the car.
Traffic en route to the Hamptons has gotten so bad that it's sending some well-heeled New Yorkers to the doctor for a medical procedure that reduces the urge to pee so often.
Crawling through increasingly insufferable summer traffic to and from their second homes, sometimes as far as 100 miles away, has left many of New York City's wealthiest — especially those on the older side — with increased bladder issues, as there are few places to stop during the multi-hour trip.
To combat "Hamptons bladder," New Yorkers who summer in the exclusive Long Island enclave are seeking a pair of specialized medical procedures: prostate artery embolization, which reduces the size of the prostate in men, and "bladder Botox," which decreases urinary frequency for women.
"A lot of people have problems with this issue. They come out to the Hamptons and have to stop four or five times on the way, but can't find a restroom," said Dr. David Shusterman, a New York City urologist who's been advertising the procedures with the tagline "Race to the Hamptons, not to the bathroom."
Shusterman said he's seen a 20% spike in patients seeking PAE procedures this spring. "I don't see them until around May, then all of a sudden, May comes and they care more," he said. "When they're in a car with a bunch of people, they're embarrassed because they have to go to the bathroom every hour."
He said he's been performing roughly 10 PAE procedures a week for the past few months, along with bladder Botox once or twice a week.
Shusterman said patients have told him about clashes in the car with friends when they needed to get off the road and find a restroom to no avail. "Thousands of people are probably fighting about this every week," he said.
The doctor himself can relate. "I can't tell you how many arguments I personally get into — I've lost three friends because I'm the driver and refuse to stop for them," said Shusterman. "There's just no place to stop."
Shusterman said about half of men between age 50 and 60 have an enlarged prostate, which causes more frequent and urgent trips to the bathroom.
The hour-long PAE procedure, performed with an interventional radiologist, stops blood from getting to the prostate, shrinking its size. The recovery is typically quick and relatively painless, Shusterman said, with patients going home the same day. He said there's a low risk of sexual side effects or urinary incontinence.
While the procedure can be covered by Medicare and insurance, Shusterman said some patients without coverage will shell out the $20,000 cost out of pocket.
Meanwhile, women fighting frequent urges on the road are turning to Shusterman for "bladder Botox," which is exactly what it sounds like. Shusterman sedates patients in a manner similar to an endoscopy, then inserts a small scope through the urethra and uses a special needle to inject the drug. The effects last for six months, so "you're covered for the entire summer," Shusterman said.
He said he's injected women of all ages, from their 20s through their 80s. The procedure is normally covered by insurance but can cost a few thousand dollars if paid out of pocket.
One 60-year-old who got the PAE procedure this spring said he's been overjoyed to obviate the need to plan rest stops in advance of the hours-long trip to his Hamptons house, which has gotten worse in recent years. "With the pandemic, most of New York just moved out to their Hamptons house," he explained. "They relocated and it's caused a lot of traffic."
Before the procedure, "it could be four hours stuck in traffic and there are no rest stops. I had to pull off an exit and find a bathroom," the man said. After receiving PAE, "there's no dread now. I'm like a kid," he said.
While getting elective surgery just to avoid conflict on a road trip might sound over the top, PAE is relatively low-risk compared to the alternatives, said Dr. Art Rastinehad, an interventional urologist in New York who performs the procedure.
Oral medications are usually the first course of action for an enlarged prostate, said Dr. Vikram Rajpurohit, an interventional radiologist at NYU who performs PAE procedures. But "they do have side effects which many patients would rather avoid," Rajpurohit said, including decreased libido and low blood pressure.
"Certainly I would not recommend PAE on a patient whose symptoms are not affecting their life significantly or to those who have not tried oral medications," Rastinehad said. "But when hearing about their interrupted drives to the Hamptons, I find that issue is usually only the tip of the iceberg."
For those who aren't at the point of seeking a medical procedure, Shusterman has some advice for preventing conflict during long car rides this summer: Stay away from that Hamptons rosé.
"Alcohol is really bad — it has a direct irritation effect on the bladder," he said. "Drink plain water. Hydrate, but don't overhydrate. You don't want to be stuck on the road with nowhere to go."
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