MINIMALLY INVASIVE TREATMENT / OPEN SURGERY
What are some of the minimally invasive treatments available?
- Laser vaporization: Anesthesia is usually required for this procedure, but patients can usually go home the same day. The technology involves placing a “cystoscope” (metal tube through which the visual lens and laser can be passed). A laser is used to burn and vaporize the obstructing or blocking prostatic tissue. Studies to date have shown limited long-term benefits.
- Microwave Thermotherapy of the prostate (TUMT): This is an office-based procedure performed with topical and oral pain medication and does not require a general anesthesia. Computer-regulated microwaves are sent through a catheter to heat portions of the prostate. A cooling system is required in some types for better tolerance. Traditionally, the best use of this procedure has been for patients who have too many medical problems for more invasive surgery or for patients who truly wish to avoid any type of anesthesia. Benefits are that there is no need for anesthesia and there is no blood loss or fluid absorption (these would be significant benefits in a person with a weak heart). Patients usually go home the same day. Men may need a catheter for one or two days after the procedure.
- The UroLift System: made by NeoTract Inc. of Pleasanton, Calif., is the first permanent implant to relieve low or blocked urine flow in men age 50 and older with an enlarged prostate. By pulling back prostate tissue that presses on the urethra, the system allows more natural urine flow. This procedure is compared to pulling back the curtains with a sash. The procedure can be done in the doctor’s office under a local anesthetic and will actually open up the urethra to allow the flow of urine and reduce the urinary symptoms of frequency of urination, improve the force and caliber of the urine stream, and decrease the number of times a man needs to get up at night to empty his bladder.
- Of course with any procedure there may be side effects and complications. Some b patients reported pain or burning during urination, increased urgency, decreased urine flow, incomplete bladder emptying, and blood in the urine. Most of these symptoms and side effects were temporary and resolved a few days or weeks after the UroLift was performed.
Bottom Line: Millions of American men suffer from symptoms as a result of an enlarged prostate gland. Certainly medications are a first line treatment option. However, the UroLift may be a permanent solution to this common problem and help men get a good night’s sleep!
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Dr. Spencer Krane
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Advanced Prostate Cancer Can Be Successfully Treated
Men with advanced prostate cancer can be treated with androgen derivation therapy. ADT reduces the testosterone level which often serves as fuel for prostate cancer cells.