How the GreenLight Laser PVP Procedure can bring relief from Enlarged Prostate Problems
One of the most common disorders in men as they age, is a benign prostatic hyperplasia, or BPH, which is simply an enlarged prostate. About half of men age 51 to 60 have an enlarged prostate, and up to 90 percent of men over age 80 have an enlarged prostate. The condition can interfere with quality of life this way: as the prostate enlarges, it squeezes down on the urethra, which is the tube that carries urine out of the body. Urination can become more difficult. In extreme cases, urinating becomes impossible. Age can also cause the bladder to weaken and the bladder wall to become thicker, which keeps the bladder from emptying completely, leaving some urine in the bladder. BPH is benign, meaning it is not cancer and it does not lead to cancer. But cancer and BPH can occur at the same time. Four occurrences indicate you may be having severe prostate problems that may require minimally invasive intervention or surgery: Inability to urinate or urinary retention Recurrent bloody urine Bladder stones Recurrent urinary tract infection Any of these indications are cause to see your doctor. POSSIBLE TREATMENTS Aside from watchful waiting, the two options
you have for BPH are medication or surgical intervention. Popular medications for this condition are known as Alpha-1 blockers. Your doctor may want to put you on a medication that will improve urine flow. A common such medication is Tamsulosin, which goes by the name Flomax, or Rapoflo (Silodosin) which works by relaxing the smooth muscle around the bladder neck and prostate. There are also other medications that actually shrink the prostate such as, Avodart (dutasteride) and Proscar (Finasteride). If none of these medications improve your symptoms either separately or in combination, your doctor may want to look at minimally invasive surgical options. “A common surgical option is transurethral resection of the prostate, or TURP,” says Dr. Marc Colton, NCH Physician Group Urologist. “TURP is a method of clearing away excess prostate tissue so the urethra can pass through unimpeded, allowing for smoother urination,” he adds. GreenLight PVP, is an alternative to TURP. The acronym PVP stands for “photoselective vaporization of the prostate,” and GreenLight is the type of laser used to achieve PVP. “With GreenLight PVP,” Dr. Colton explains, “a laser actually melts the prostate tissue; it’s like butter. The tissue then coagulates right away, so there is very little bleeding.” The laser is inserted into the penis (under general anesthesia) and threaded through the urethra to the site where the enlarged prostate surrounds the urethra.
Laser light then vaporizes the excess tissue. The heat cauterizes the blood vessels, so the bleeding is minimal. This procedure is done on an outpatient basis at NCH. The patient generally has a catheter in for just 24 hours and is back to his normal activities—including exercise—in about a week. Patients typically have good long-term
Marc Colton, MD
success in improving their flow of urine, and erectile dysfunction generally does not come into play, as it can with more invasive surgeries. Dr. Colton, who started performing GreenLight Laser PVP in 2004, appreciates how easy the procedure is on the patient and how fast the recovery is. “Every mechanic has his tool, and this is mine,” he jokes. He was the first surgeon to use the tool in New Jersey and has gone on to teach the procedure to many other surgeons, and to perform some 1,000 of the surgeries himself. GreenLight Laser PVP is available to many men, though there are a few instances when the procedure would not be appropriate. If you have medical issues that prohibit you from having anesthesia and if your bladder is not working correctly, then GreenLight Laser PVP is not for you.
GREENLIGHT XPS ™ LASER THERAPY SYSTEM: A SYSTEMATIC APPROACH TO VAPORIZATION
Advantages of GreenLight Laser PVP over TURP An outpatient procedure Quicker recovery Less bleeding than TURP Can be performed on patients with very large glands and who are on blood thinners.
1. Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating? 2. Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating? 3. Over the past month, how often have you stopped and started again several times when you urinated? 4. Over the past month, how often have you had a weak urinary stream? 5. Over the past month, how often have you had to push or strain to begin urination? 6. Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning? Scoring: 0-7 points Your BPH Symptoms are considered mild. 8-19 points Your BPH Symptoms are considered moderate. Make an appointment to talk with your urologist or primary physician. 20-35 points Your BPH Symptoms are considered severe. Make an appointment to talk with your urologist or primary physician.
Has same long-term results Test Your Prostate Health
Are you wondering about your prostate health? Take this quiz from the American Urological Association to find out whether your symptoms warrant a check from your doctor. Answer key:
Not at all = 0 points Less than one time in 5 = 1 point Less than half the time = 2 points About half the time = 3 points More than half the time = 4 points Almost always = 5 points
Give yourself a numerical score for each of these questions.
Then add up your total at the end.
For more information about NCH Physician Group Urology or to make an appointment with Dr. Colton, call (239) 624-1160
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