Jul
19
RETROPUBIC PROSTATECTOMY w5tbpqac7u
In this surgery the same type incision is made as in the suprapubic operation. The muscle is separated and the sac containing the intestines is moved away from the bladder.
Now the surgeon makes an incision into the prostate capsule and removes the enlarged gland. The tissue removed is tested by a pathologist to determine if there is any cancerous growths present.
Now the surgeon sutures or cauterizes the bleeding vessels and the catheter with the three way tube is placed into the bladder. This catheter is usually the same type as used in a TURP operation. Next the balloon is inflated to keep the catheter in place.
All that is left is for the surgeon to “close”. The prostate capsule is sutured shut and the muscles, fascia and skin are put back in place and stitched closed.
This operation differs from the previous one since the bladder itself was not opened. It’s slightly simpler with less violation of the body. This means there is no need for the second catheter through the belly to drain the bladder.
The draining and irrigation of the prostate needed can be done with the usual three-way catheter. Most urologists say that this operation is less stressful to the patient since the bladder is not cut open, so it doesn’t have to recover.
General recovery procedures and time is about the same for either type of operation. Which type your urologist might suggest would be determined by the individual patient’s condition and sometimes the doctor’s preference.
In surgery for the prostate, the general rule is that a medium sized enlarged prostate and smaller ones can be successfully removed by the TURP method. However when the gland swells in size to over fifty to sixty grams, the urologist will usually do one of the other operations because of the difficulty in scraping out that much tissue and drawing it out of the urethra.
In these cases the larger prostate removal by the retropubic or suprapubic is simply the most efficient method to be used for the well being of the patient.
OTHER TYPES OF PROSTATE SURGERY
Perinea) prostatectomy is another kind of open surgery for the prostate but it is seldom used today. This procedure is quick and simple to do, but almost always severs the nerve bundles that control erection and leaves the patient Impotent.
Doctors back in the 1930’s often used a two stage operation for the prostate. The first stage was opening and draining the bladder. Then two weeks later they would go in and remove the prostate. It is seldom used today.
With the new treatments now coming into focus for the prostate, particularly BPH, there may be a general slowing in the number of surgeries needed. Any surgery has risks but with the prostate the risks seem to be reasonable in regards to impotence and incontinence, the two problems most men fear the most.
With the development of the new drugs, we may see products that will cause the enlarged prostate to shrink without objectionable side effects. With the increased use of the balloon as at least a temporary treatment for BPH, and other inventive methods, some experts are predicting that the use of surgery will not be required as often in future years as it is today. Only time will tell. As the public learns more about the male prostate and BPH, more men will demand non-intrusive treatments whenever possible. Right now a lot of men are hanging their hopes on the new drugs Hytrin and Proscar.
Jul
18
TUIP: TRANS URETHRAL INCISION PROSTATE
July 18, 2009 | Leave a Comment
TUIP: TRANS URETHRAL INCISION PROSTATE
The TUIP is simply a pair of incisions made on the sides of the bladder neck that closes the bladder off from the urethra. The incisions are made through the urethra and is a simple procedure. Urologists are not sure why this works for the relief of BPH problems, but it does. Often urine peak flow is greatly increased, getting up at night is reduced and hesitation and some of the other less serious BPH problems are lessened.
This procedure is much like a TURP for the equipment used and the insertion. The electric knife makes only the two incisions and no removal of prostatic tissue is done. This is another option a patient with really bothersome BPH has to find relief
Jul
17
DANGERS AND SIDE EFFECTS
Let’s take a closer look at TURP and the statistical dangers and side effects.
1. Retrograde Ejaculation. This is in effect defacto sterilization. There is no other way to describe it. A vital part of the reproductive system in the male is contained in the prostate and other elements are injected into and flow through the urethra situated inside the prostate.
When most or all of the prostate is removed, the fluid that the prostate produces to lubricate and carry the sperm down the urethra is also gone. Now when orgasm takes place, muscular contractions propel the spermatozoa and fluid from the prostate and seminal vesicles into the prostatic urethra.
At the same time this happens, the neck of the bladder closes so the fluids must go down the urethra and out the penis. But after TURP surgery, this bladder neck closure is usually cut away to provide more space for the urine flow.
With the bladder neck open, the sperm and the fluid take the path of least resistance and are propelled into the bladder instead of out the penis.
This is called retrograde ejaculation. The sensation of the orgasm is the same for the man, there just isn’t any outside ejaculation.
With many TURP patients this is not a problem. Most men in the good TURP surgery candidate pool are no longer interested in fathering children. In most of the cases when a patient is told about this drawback and result of the TURP, he will not have any major problems with it. The trouble comes when a patient is not told about retrograde ejaculation and finds out on his own and is furious that he wasn’t informed before the operation.
In the extreme case where fatherhood is still desired, the ejaculate can be retrieved after the next urination after the orgasm, and the semen gathered and preserved and used in an insertion procedure into the woman’s vagina, the same as any artificial insemination. It works.
2. Bleeding. TURP involves a lot of cutting of tissue and the enclosed blood vessels. Bleeding is a natural course of events. Most of the bleeding is stopped during the operation by cauterization.
As with any cut or wound, a scab develops. This should stay for two or three weeks and then fall off. By then the blood vessel should be healed. If the scab falls off sooner bleeding usually begins and shows up in the urine.
This happens in only about one percent of all TURP patients and is often caused by straining to pass a stool. Usually this bleeding can be helped by a patient drinking lots of fluids to cleanse the area. Only rarely is there a need for the patient to be readmitted to the hospital to correct the condition.
3.1ncontinence. (The inability to control voiding of urine.) This is one of the big fears of a TURP surgical patient. It is embarrassing and distressing, and can lead a patient to total social isolation.
Incontinence happens to from one to four percent of all TURP patients. Many urologists claim it is less frequent, and say it can be the result of the normal surgical risk factor.
The problem comes when the electric knife cuts too near the sphincter voluntary muscles which control the flow of urine. If these muscles are damaged then the patient may become incontinent.
The other means of continence is the external urethral sphincter. Damage here can lead to a stress type of incontinence.
Incontinence after a TURP operation does not have to be permanent or irreversible. There are drugs that can be used to relieve the situation. Another possibility here is the use of an artificial sphincter.
At any rate this is one of the areas that you should discuss with your doctor prior to any prostate operation.
4. Impotency. Experts in this field say about five percent of all TURP patients come out of the operation and are impotent even though they were not that way going in.
Impotency is simply a man’s inability to achieve an erection, or to maintain it long enough for vaginal penetration.
The “manliness” of a male is a highly subjective area, and statistics on this element may be dramatically wrong in either direction. Many men may say they are able to achieve an erection and have intercourse when they are 70, 75, even 80. But age and other problems may have reduced that libido drastically so that even they were not totally cognizant of their ability to achieve a working erection. Time and age does this to all men.
Sometimes such an operation is a handy whipping boy for the sudden realization of impotency.
In any case, impotency is a fact of life for some of the men who have TURP operations, and you should know about it now. There is one sure way to develop impotency in a TURP patient. That is to damage one or both of the nerve bundles that are on each side of the prostate. These bundles are outside of the true capsule of the prostate. That means they are well outside of the area a surgeon’s electric knife should be operating to remove the prostatic tissue clogging the urethra. This is to say that a TURP properly carried out, should not harm these nerve bundles and that should not be the reasons for any impotency.
Some psychologists say that sex is at least 75% mental. This is why the cause of impotency, especially in men from 60 to 90 is extremely difficult to tie down. It may have been there before the operation and not recognized. The operation might create a psychological block preventing the erection. A now and then lack of a man’s ability to “get it up” is not uncommon even in younger men. The trauma of the operation, even the thought of some danger to a patient’s “manhood” and a negative spousal situation all can combine to create a psychosomatic impotency. This may be of a short or long duration.
There are drugs that can be used to help this impotency, and several devices that will be covered in a later chapter. Impotency, while not a large factor, is one that the surgery candidate for TURP should be well aware of.
Jul
16
TRADITIONAL PROSTATE SURGERY.
July 16, 2009 | Leave a Comment
The electrical wire loop emerges from the end of the tube and is used to cut away the prostatic tissue. Power is applied to the electric loop by the use of a foot switch when the surgeon wants to cut.
As he does this, the surgeon is watching the procedure through a lens that is located just outside the end of the penis.
When bleeding occurs inside the urethra, another foot pedal is pressed and the bleeding part is sealed off by cauterization so it won’t bleed. During the surgery the entire area is washed by glycine.
After the surgeon decides that he has removed enough of the enlarged prostate, the chips and shavings of the prostate tissue are removed with the glycine wash and sent to a pathologist who studies them to see if there are any beginnings of cancer of the prostate.
The surgeon may elect to remove most or all of the prostate but he will not harm the prostate’s surgical capsule. This new hole that has been created through the overgrown prostate now becomes a urinary canal. This means that the prostate enlargement tissue was growing around the urethra gradually closing it down and narrowing it. The inner walls of the urethra have been cut away carving a new canal through the prostatic tissue growth.
After the cutting is done, a thin, flexible rubber or plastic tube is then passed through the penis and urethra and into the bladder so urine can be drawn from the bladder.
This tube remains in place for a few days because of some bleeding that may take place in the prostate. When the tube is removed, the patient will be able to urinate normally again.
This catheter, used after the TURP surgery, consists of three lumens or tubes. One is used to send in and remove a wash of saline solution, salt water, into the bladder to irrigate and clean it. This saline solution usually is used for twenty-four hours after surgery.
The second tube is used to draw off urine. The third usually has a small balloon attached and is inflated so the catheter will not fall out.
The catheter to draw urine from the bladder stays in place for two days after surgery.
Most patients feel good enough to get out of bed a day after surgery and are feeling much better after four days. Yes, you can walk and talk and sit down with the catheter in place. It usually comes out on the second day and no pain is involved.
The surgeon will deflate the balloon and the catheter can then simply slide out. The following day, most patients are discharged and sent home. Hospital stay: two days.
Most TURP patients get a prescription for antibiotics to be taken by mouth for one to two weeks after the surgery. This is a precaution to ward off any infection.
Post surgical suggestions from his urologists will probably advise the patient to take hot baths rather than showers for a while, drink lots of fluids, avoid spicy foods and watch out not to become constipated.
There won’t be any touch football games for a while, but most of the patient’s activities can be resumed, including driving, sitting at a desk and taking walks.
If there is any trouble it probably will be a slight burning during the first two weeks when he urinates, and even small amounts of blood in his urine. If this happens, the patient should call his urologist and report the problem just to be on the safe side.
When can you get back to work’? These are general guidelines. You’ll follow your doctor’s orders here. They will depend on the doctor, the patient and how well he recovers. Generally: If you do heavy manual labor, best to wait four to six weeks. Moderate labor will call for three to four weeks of vacation. The mental giant behind a desk or in a white collar position can get back in his harness after two weeks.
One caution. The TURP patient should hold off any sexual activity for six weeks after surgery. This will allow the canal through the prostate to heal completely.
The TURP surgery is performed about 400,000 times a year in the U.S. and the numbers probably are rising with the increase in percentage of our male population reaching the BPH age.
PROSTATE SURGERY
When you and your urologist decide that the best way to handle your BPH or other prostrate trouble is surgery, you have another decision to make. Which type of surgery will do the job that needs to be done?
Today, about 95 % of all BPH surgery uses the standard transurethral resection of the prostate, or TURP, as it is called.
Your urologist will explain to you in detail what this surgery involves.
The TURP is what surgeons call a closed operation. That simply means that there is no incision made in the body to get at the problem.
The TURP uses a surgical instrument that is inserted into the penis through the urethra. He’ll point out to you that this is done after the use of anesthesia. The instrument is a nonflexible hollow tube that extends into the narrowed portion of the urethra inside the prostate.
Inside this tube the urologist will insert a fiber optic micro-lens system that doctors call a resectoscope. This device includes a fiber optics light source, a lens and a electric wire element for surgery. The light inside the urethra lets the doctor see the problem and determine the severity of the problem.
Jul
15
OVER-THE-COUNTER,
THROUGH THE MAIL REMEDIES
Up to two years ago there had been a thriving over the counter and through the mails business of selling non-prescription compounds and “cures” and treatments for BPH.
Several years ago the Post Office Department began challenging many of these products sold through the mail on grounds that they were advertised misleadingly, and that they did not do what they claimed to do. Simple misrepresentation which could ban them from the mail.
That campaign by the U.S. postal authorities put a lot of people out of business who were selling various mail order non-prescription products to treat the prostate.
In March of 1990, the Food and Drug Adminstration said it would ban the sale of all non-prescription drugs used to treat enlargement of the prostate gland. The FDA said their review of the products found little evidence that any of them eliminated, arrested or treated the condition called benign prostatic hypertrophy. There was no date given for enforcing the ban or activating it.
The FDA, evidently not keeping up with current developments in the field, said surgery was the only effective treatment for BPH. A lot of urologists and specialists in the drug field will argue long and hard with their dictum with the various minor-surgical techniques we’ve discussed so far and the new drugs being developed.
What the FDA order does is ban non-prescription products that are advertised for the treatment of the prostate. They did not, and can not ban the sale of certain chemicals or compounds that have been considered by many since the Feinblatt/Gant study in 1958, to be beneficial to reduce BPH symptoms. These chemicals, mainly amino acids, are used in many of the soon to be banned products.
The study was conducted by Dr. Henry M. Feinblatt and Dr. Julian C. Gant and reported in the Journal of the Maine Medical Association in March of 1958, Volume 49, Number 3.
The study deals with the “Value of glycine, alanine and glutamic acid combination,” in the treatment of BPH.
These three chemicals have generally been used by dozens, perhaps hundreds of non-prescription compounds aimed at the general public since 1958.
Were these remedies straight out of the Wild West’s Medicine Man’s wagon of hokkum, or do they have some beneficial results that the traditionalist medical men on the FDA panels refuse to recognize?
Let’s look at the Feinblatt/Gant study that started it all.
The doctors had been using these three amino acids to treat their allergy patients. One of the patients mentioned that his urinary problems had improved since he’d been taking the medications from the doctors.
This stirred their imagination and the two medical men decided to try the three way amino acid combination on a group of non-allergy patients. The tests proved that these BPH sufferers had a dramatic relief from their urinary and BPH symptoms.
They moved from there to a clinically stringent test. A group of 40 patients with benign prostatic hyperplasia were treated with glycine-alanine-glutamic acid capsules for three months.
The patient age range was from 37 to 75 years and weigh from 101 to 192 pounds. BPH complaints ranged in duration at the start of the test from one to six years by various patients.
Placebo capsules were given to half of the patients and the amino acids to half. The patients response results over three months were charted. (Understand here that most such tests should be conducted over six months for best reliability.)
Results of the clinical tests were published in this way. For the control group taking the amino acids, the doctors said the size of the prostate was reduced in 92% of the cases. Nocturia was relieved in 95% of cases. Urgent urination was relieved in 81% and frequency in 73%. Discomfort was reduced in 71% of the cases. No such results were observed in the placebo taking control patients.
Other medical authorities have conducted tests along the same lines to confirm or deny the Feinblatt/Gant findings.
In the Journal of the American Geriatrics Society in 1962, Dr. Frederick Damrau of New York City reported such a test. His conclusions were similar. He said the combination of the three amino acids were used in a controlled cross-over test in forty cases of BPH. After three months on the test the patients reported nocturia was relieved or reduced in 95% of cases, urgency down in 81%, frequency lowered in 73% and delayed urination in 70%. Dr. Damrau said there were no adverse side effects or adverse reactions to the amino acids.
Other evidence the FDA ignored or discounted comes from Japan where a series of nine clinical tests were conducted at the department of urology of Kyoto University in Kyoto.
Some of these tests were double blind, which means there was no way the participants could have any idea if they were receiving the test material or a placebo.
The tests were published in the Acta Urological Japonica, volume 14, 1968.
Results for the amino acids therapy for hypertrophy of the prostate showed that the glycine-alanine-glutamic acid capsules were administered to thirty six cases of diagnosed uncomplicated BPH. The capsules gave satisfactory results in relieving subjective and objective symptoms and no side effects were observed in any of the patients.
In another of the tests, statistical results showed that improvement of symptoms were as follows:
• Urinary frequency reduced in 77.7%
• Nocturia relieved in 68.4%. Difficulty of urination relieved 77.3%
• Feeling of residual urine relieved in 71.4% Side effects were found in only one case and that was relieved with a gastrointestinal drug.
Now, one of the obvious questions is this: If these amino acids are so good, as these tests tend to show, why hasn’t one of the huge pharmaceutical giants leaped on the band wagon and brought out a tested, recognized and approved by FDA combination of these amino acids for the prostate sufferers?
The logical answer could be that their own testing did not match the results of the tests shown above. Or, the situation may be that the amino acids would not be a “proprietary” compound that they could patent, protect and profit from. It would be similar to spending millions to test a salt pill, and bring it out only to find that every othercompany could make the same salt pill.
Jul
14
INFECTIOUS AND NONINFECTIOUS PROSTATITIS
July 14, 2009 | Leave a Comment
INFECTIOUS AND
NONINFECTIOUS
PROSTATITIS
Prostatitis is an inflammation of the prostate gland and it is one of the most common of men’s diseases keflex tape . There is no age limit here — prostatitis attacks any man from teenager to grandfather in his nineties celebrex half life .
How do you know if you have it? You’ll be absolutely certain that something is wrong inderal for cats . Prostatitis is not subtle omeprazole and irritability . A case of acute prostatitis may bring on a sudden fever, chills, nausea and vomiting besides urgency of urination, hesitancy, burning pain during urination and even pus or blood in the urine apoe quinapril .
Most family physicians who diagnose acute prostatitis will suggest the patient go to a specialist, the urologist fosamax tumors .
Prostatitis can be caused by infection, irritation and congestion or a combination of these problems geodon msds . Many urologists will tell you that sometimes there is no apparent cause of the condition viagra teens teenager .
This ailment does respond well to treatment, even if it is a bit slow sometimes menopause high testosterone .
The infectious type of prostatitis results from some microorganism or bacteria that has invaded the prostate jitters from celexa . With its tough outer shell, the prostate is hard to get into dipyridamole allergic reaction . But it can be infected through the bloodstream, the lymph system, and the urine motrin package insert .
A lot of the infections come from bacteria from the colon prilosec long . However, antibiotics now can be used to knock out this type of infection before it gets serious effexor side effects headaches .
Bacteria can get into the prostate from sexual contact amoxicillin price overnight . The yeast infections as well as gonorrhea can be sexually transmitted order tetracycline . This danger is just another reason to be safe in your sexual life, wear a condom evanescence lithium guitar tab .
Some people can develop prostatitis simply by eating or drinking certain foods or beverages drug-herb interraction metoprolol aconite . On the avoidance list for some people are coffee, gin, red wine and Scotch whiskey arv efavirenz . Aromatic oils are used to flavor these drinks and that is what irritates the prostate and sets it to complaining leg lipitor pain .
We mentioned gonorrhea as one problem ibuprofen and benedryl . At one time it was the most prevalent infection of the male urogenital tract floxin otic . But now with the better antibiotics, this sexually transmitted social disease can usually be cured quickly benadryl prednisone interactino . A fast cure has the added benefit of stopping the infection before it can travel to the prostate avapro micardis .
Sometimes abscesses do develop in the prostate from gonorrhea unichem laboratories rimonabant conterfiet . This is often because the man has an antibiotic resistant strain or did not get prompt enough treatment to kill off the disease quickly effexor side affects uses . The abscesses result in the same usual symptoms of acute prostatitis evista and respiratory infections .
A urine sample usually shows up minute amounts of the prostate emissions and microscopic examination of the emissions will help the doctor determine what bacteria have made their attack and that will determine what treatment is prescribed does metformin help in getting pregnant . Most prostatitis clears up quickly with the proper medication 3v lithium fishing battery .
Jul
14
HYTRIN IN PROSTATITE TREATMENT.
July 14, 2009 | Leave a Comment
HYTRIN …. AVAILABLE NOW
There is one drug on the market now, and available, that researchers at Abbott Laboratories of Chicago say will do the job of relieving BPH symptoms.
This is Hytrin, Abbot’s brand of terazosin, approved by the FDA in 1987 as a once-a-day pill for high blood pressure.
Dr. Atul Laddau, Abbott’s head of clinical research, says their own clinical tests of two years show that Hytrin relieves pressure on the urethra almost immediately and reduces other symptoms in about two thirds of the test patients with BPH. Some urologists are using Hytrin because it is now on the market, and because of the reported quick results. You don’t wait three months for relief here.
There are some unfortunate side effects with Hytrin. These are said to be dizziness, fatigue and occasionally fainting attacks. Even considering these side effects. Hytrin, with its two-thirds success rate and its availability, should be one of the drugs that you talk to your doctor about. There are other terazosin medications on the market beside Hytrin. Cost of these pills is said to be about $15 to $20 a month.
Jul
13
PROSCAR IN PROSTATITIS TREATMENT
July 13, 2009 | Leave a Comment
PROSCAR
One of the drugs of the future for controlling BPH may be a product now in final testing by Merck & Co. called Proscar. This drug blocks an enzyme that stimulates prostate growth. The Merck researchers say that the male hormone testosterone undergoes changes in the prostate gland and this is believed to be the primary factor in unwanted prostate growth when a man gets into his 40’s and 50’s and later.
By blocking this enzyme and refusing to let it change the testosterone, it would also stop the growth of the prostate.
Researchers say they are still in testing on the drug but it is in human clinical trials, one of the last of the procedures.
Using 350 patients in one clinical test, the drug reduced the size of enlarged prostates an average of twenty-eight percent. One third of the test patients also had a “dramatic improvement” in their urine flow.
Dr. John McConnell, assistant professor of urology at the University of Texas Southwestern Medical Center in Dallas, said: “The drug is highly effective from a biochemical point of view. It does shrink the prostate.”
He went on to say since only about one-third of the patients had an improvement in urine flow, the drug is not applicable to all men or all BPH cases.
One advantage of the Proscar treatment is that it has resulted in no side effects, at least so far in the testing. Side effects have been the killer of most prostate drugs so far.
Proscar is in final testing and with success should win the Food and Drug Administration approval for sale in the “early 1990’s”. That could still mean that it’s three or four years away.
One drawback to Proscar has been determined so far. It takes “about three months” before the prostate shrinks enough to help in urinary flow problems.
Merck is excited about the new product from a breakthrough standpoint, but also because it could have a great financial future. The market for such a medication that works, is said to be in the hundreds of million of dollars a year. The quickly expanding male population in the “prostate years” adds to this sales potential. This is one product to watch closely.
Some drug industry spokesmen say Proscar and Merck may be facing a problem: getting urologists to prescribe a medication that could cut their income by reducing the 400,000 prostate surgeries a year. Most urologists discount this saying they welcome another tool to fight prostatic disease.
Jul
12
PROSTATITIS: CAN DRUGS BE USED INSTEAD OF SURGERY? RELAXATION DRUGS.
July 12, 2009 | Leave a Comment
CAN DRUGS BE USED INSTEAD OF SURGERY?
Over the years there have been many attempts made to find a drug that would shrink the prostate gland. The scientists worked on the belief that the enlargement of the prostate had something to do with the male hormone production.
This led to the use of female hormones that did shrink the prostate and help the BPH problem and reduced or eliminated the symptoms. The only trouble was that it also reduced and eliminated the male sex drive and often led to sterilization and impotence of the patient.
After that the lab men worked on drugs that would simply block the production of testosterone produced in the testicles. They came up with Leuprolide (lupron) which blocks ninety percent of the body’s total production.
Another companion drug used at the same time, Flutamide (eulexin), eliminates the other ten percent of testosterone made by the adrenal gland.
What these drugs do is effectively castrate the man by chemical action. This reduces the male libido, his sex drive, and sterilizes him and makes him impotent. These are mighty tough side effects even for a man in his seventies just to shrink the size of the prostate.
These drugs are most often chosen when a man has an extreme case of BPH or cancer of the prostate, and his sexual life is no longer a factor in his life whether he’s 65 or 80 years.
For most men the sexual side of life is always a vital part of their existence. It’s like watching a shiny new bus stop at your corner. It’s nice to know the bus service is always there, even though you seldom use it any more.
RELAXATION DRUGS
Some urologists find that the use of a drug such as Minipress (prazosin hydrochloride) will relax the smooth muscles surrounding the prostate. The purpose here is to get these muscles to relax or loosen to allow the prostate to expand slightly outward and thereby ease the internal pressure on the urethra.
A second drug used for the same purpose of relaxation of the muscles around the prostate is Terazosin. It relaxes the muscles and greatly reduces the spasms that these muscles frequently have which slow or prevent urination.
BPH is a highly subjective ailment. What bothers one patient may be little more than a minor and unnoticed irritant to another. Some patients who use one of these drugs may report relief from some of their symptoms, while others say they have no effect whatsoever on their life style.
Tests have shown some urologists that the use of Minipress and Dibenzyline drugs have made specific improvement in patient symptoms. Studies have been done to measure the voiding flow rate and residual urine before and after the use of these drugs, with an average of 60% improvement.
Jul
11
PROSTATITIS: LASER MINOR SURGERY AND OTHER NON MAJOR SURGICAL APPROACHES.
July 11, 2009 | Leave a Comment
LASER MINOR SURGERY
Yes, the laser is now finding its way into prostatic surgery. For some patients the balloon treatment doesn’t open the urethra enough. To help these patients, Dr. Roger S. Warner, a urologist at New York University in Manhattan, wields his laser to remove some of the offending tissue around the urethra, and then follows that up with the use of the balloon dilation. Dr. Warner said this treatment helped twenty-five out of twenty-nine patients treated.
Other doctors say that laser surgery, first used in medicine in the 1970’s, is only scratching the surface of its potential. In the future they say there will be a much greater use of the laser. Lasers can also be used to vaporize benign and malignant growths, and it’s all done quickly and simply without the patient trauma of an open surgery.
The role of laser surgery in urology is limited but it has a great potential. Dr. Israel Barken, a urologist in private practice in San Diego, and a researcher at University of California at San Diego Medical School, has a patent on a device to use in laser surgery of the prostate.
Intrasonix Company from Boston in conjunction with the Lahey clinic has developed a new device by the name of TULIP. They have used it in operations on 25 dogs so far with promising results.
In the future, from mid 1990, you may wish to ask your urologist about the possibility of having laser surgery by your urologist. Right now it’s still experimental, but work is going on in three places aroud the world.
OTHER NON MAJOR SURGICAL APPROACHES
Dr. Terrence R. Malloy, chief of urology at Pennsylvania Hospital in Philadelphia, attacks the enlarged prostate tissue with ultrasound waves. The tissue is turned into a pulp and dislodged and then sucked out of the body by an aspirator.
Some research is now being done with microwaves. They are aimed directly at the enlarged prostate. Testing is now underway to see what results are of attempts to shrink the enlarged prostate tissue, thereby relieving the pressure on the urethra.
Another experimental type of minor surgery is the use of cryogenics. This utilizes a probe through the penis and urethra and into the heart of the enlarged prostate. The probe then releases liquid nitrogen into the enlarged tissue.
This intensely cold fluid freezes and shrinks the tissue and destroys it which relieves the pressure on the urethra. More experiments and results of this type of cryosurgery will be reported in the first half of the 1990’s we are sure.
Another new development in the opening of the urethra through the prostate is the insertion of a spring like spiral device that mechanically keeps the urethra open. This is a new technique and while some urologists have the springs available and can insert them, we expect much development in this area of the open urethra in the coming years.