Hammed Ninalowo (Lagos, Nigeria) and Scott McLafferty (Columbus Radiology Corporation, Cincinnati, USA) performed the first prostate artery embolization (PAE) in Nigeria on 29 August 2019.
The patient was a 77-year-old man with a long history of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS), according to Ninalowo and McLafferty, and was initially seen for a consultation in July 2019. Describing the patient’s condition prior to treatment, the interventionalists tell Interventional News that, “A few months prior, he had developed acute urinary retention, necessitating placement of a suprapubic catheter. Since that time, he had a significant worsening in his quality of life due to catheter dependence. The presence of the catheter caused him both significant physical and emotional distress, with the patient regressing into a state of depression, and refusing to have guests around his home. Due to a complex medical history including a prior coronary artery bypass surgery, prostate surgery was not an option.”
Ninalowo and McLafferty say they are “proud” to have performed the first PAE in Nigeria, and to help this patient. “At the time he was seen in clinic”, they recount, “it was clear he was desperate for a solution and prepared to leave Nigeria to find one. However, with [the] continued awareness of local physicians and the possibilities of interventional radiology, he was sent to us for consideration of minimally invasive PAE.”
PAE is a minimally invasive treatment for LUTS secondary to BPH, and is frequently used to treat men who have failed traditional medical management. Ninalowo and McLafferty explain that this is the story for a large number of older men in Nigeria, saying “many are desperate for a solution to improve their symptoms or be free of their catheter dependence”. However, they also state that local options have been limited, especially in high-risk non-surgical candidates.
“Myriad Nigerian men suffered and did not have the means to seek PAE as a therapy locally”, they comment. “This is no longer the case. By offering this in Lagos, we create the first step towards improving access to care for these men.”
Nigeria is a country with a long history of its citizens traveling internationally for medical care. Five practising interventional radiologists today serve a country with a population of 200 million people. Ninalowo is helping to lead the effort to establish greater access to interventional radiology for all Nigerians. Following his own medical training in the USA, he founded the organisation IRDOCNIGERIA, which aims to train an additional 100 interventional radiologists in his home country over the next decade. The first interventional radiology training programme in Nigeria also launches this month, with Ninalowo at its helm.
McLafferty expands on the importance of this work: “I think this model of a local physician trained in America repatriating his skills to his own people is the key to achieving a sustainable interventional radiology practice in a virgin country. His [Ninalowo’s] practice, IRDOCNIGERIA, currently offers high-level interventional radiology procedures in Lagos, Nigeria.
“In addition, Ninalowo and I are managers with RAD-AID International’s IR4Nigeria effort to establish a sustainable IR training programme in Nigeria. With this, we have established a primary collaboration with the Nigerian Society of Interventional Radiology (NiSir), and also established a primary training site at the University College Hospital in Ibadan, Nigeria. The enthusiasm of local radiologists to learn interventional radiology has been tremendous and we plan to continue to provide immediate access to simple and complex interventional radiology procedures and help build long-term sustainability.”