Benign Prostatic Hyperplasia: Innovations in Management
The information provided in this book is aimed at a wide audience including private practice and academic urologists, research fellows and doctors in postgraduate training, and basic scientists interested in prostatic pathology. Read more Read less. K; Softcover reprint of the original 1st ed.
No customer reviews. Share your thoughts with other customers. Besides aging, other factors that heighten the risk include a family history of BPH , diabetes, heart disease, obesity, and lack of exercise.
Benign Prostatic Hyperplasia | Tampa General Hospital
Tampa General Hospital offers an innovative procedure that is clinically shown to address the symptoms of benign prostatic hyperplasia while significantly reducing the risk of side effects associated with traditional BPH surgery. Called prostate artery embolization, or PAE, this procedure is minimally invasive and is performed on an outpatient basis, requiring less than six hours at the hospital.
Instead of removing the prostate, PAE simply cuts off the blood supply to the organ, causing it to shrink and eliminating BPH symptoms. The procedure is performed through a small incision in the left wrist. The procedure, in early clinical trials, has yielded better results in massively enlarged prostates, which often cause more complications when treated with traditional surgery. It involved "shaving" the enlarged prostate tissues with an electric current delivered through a wire loop. While this technique worked well, its' side effects could include bleeding, urinary incontinence and erectile dysfunction.
Today, two newer procedures are performed in the urologist's office.
For patients with mild to moderate BPH with no middle lobe, there is a stapling procedure known as UroLift where the physician places the patient under local anesthesia or conscious sedation and lifts and staples the prostate to open up the urethra. Because it pulls the prostate out of the way, this approach offers rapid relief, but it cannot be done if the prostate has a middle lobe. The procedure takes about minutes, and patients return to normal activities in about 3 days.
Results are not always permanent; symptoms could eventually return. The second procedure, known as Rezum, is also performed with local anesthesia or conscious sedation and is available for patients, regardless of the presence of a middle lobe.
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The physician uses a radiofrequency device to deliver drops of water vapor to the prostate. Condensation of the water vapor releases energy that causes the surrounding cells to die and results in retraction of the prostate and opening of the urethra. The procedure takes about 10 minutes, and patients return to normal activities in 3 days.
It takes about 1 month for patients to get the full effect. For patients with moderate to large prostates or who have a large median lobe, laser surgery is often the preferred choice.
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This type of procedure is useful for men who may also have had other procedures in the past, and now prostate re-growth is causing obstruction again. During this procedure, usually performed in a hospital, the laser vaporizes the tissue obstructing the urethra, opening it up almost immediately.
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There are several laser wavelengths available to treat BPH. The most popular of these wavelengths are holmium and Photoselective Vaporization of the Prostate PVP , also known as "greenlight laser. The greenlight laser is a minimally invasive technique with good results. The procedure uses high-powered laser light, combined with fiber optics, to quickly vaporize the overgrowth of prostate cells.
This procedure takes about 1 hour and provides patients quick symptom relief, ease and comfort of urinary flow, and minimal short-term side effects. Holmium lasers have been used for more than 20 years to treat many urologic conditions. These lasers have the ability to interact with soft tissues while keeping known safety margins and controlling bleeding. Usage of this versatile tool for BPH treatment relies specifically on the high-power systems with relatively high energies and, more importantly, high repetition rates, which are important for efficient tissue effect.
A procedure called Holmium Laser Vaporization of the Prostate HoLVP , which uses high-powered holmium lasers, has some advantages over PVP for patients with BPH including, in my experience, less bleeding and the ability for urologists to treat men with larger prostates. HoLVP is a solid option for small to moderate-sized prostates and those with a large median lobe.