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Medical Edge Newspaper Column from Mayo Clinic

NEW LASER TECHNIQUE EFFECTIVE FOR ENLARGED PROSTATE

DEAR MAYO CLINIC: I wonder if you can help me. I am a 67-year-old man in good health. After weakening of my urine stream and seeing my daily routine get more and more disrupted by the urgent need for frequent urination, I finally went to my doctor. He diagnosed me with benign prostate hyperplasia. So I guess that’s the good news — it’s not cancer.

The bad news is that he says the best ways to take care of it are minimally invasive surgical techniques or conventional surgery. I don’t like these options because I hear the recovery is long and hard, and the problem may return pretty soon after minimally invasive procedures, and conventional surgery may run into bleeding, with a hospital stay and other complications. I heard about a new laser treatment for prostate troubles. Could it work for me? — Cedar Rapids, Iowa

ANSWER: Before I address laser treatment options, I’d like to offer a little background on your condition. Benign prostatic hyperplasia, or enlargement of the prostate gland, can disrupt your life significantly, restricting urine flow, causing a weak urine stream and urgent, frequent urination throughout the day and night. It affects 40 percent of men in their 50s, and most men in their 80s. In many, BPH leads to urinary obstruction.

The effectiveness of laser surgery in removing prostate tissue depends on the type of laser used. I can, however, tell you about excellent results with a new kind of outpatient laser treatment called KTP, or “green light” laser. The procedure itself is called photoselective vaporization of the prostate. The technique was developed at Mayo Clinic more than seven years ago to help address some of the concerns you mention. Physicians from around the world who have undergone special training now perform the procedure.

Usually, PVP is done as an outpatient, and patients are comfortable very soon after the procedure. Although some patients do not require a urinary catheter (tube that drains urine), others may need one for a day or so. Because there is typically little or no bleeding with PVP, it can be performed in patients who take blood thinners. Complications have been relatively few and mild. And by removing the excess prostate tissue, PVP can resolve the obstruction problem and relieve symptoms. As a result, normal bladder habits return.

As you noted, there are other alternatives, such as minimally invasive surgical techniques, conventional surgery or other laser procedures for treatment of BPH. Ask your doctor about them — and talk to friends who have had these treatments to learn about their experiences.

When discussing treatment options, take special care to ask your physician about recovery period, complications and “durability” of results, which means how long the beneficial results last before symptoms return.

— Reza Malek, M.D., Professor Emeritus of Urology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Benign Prostate Hyperplasia
Appointment Information
More Information on Benign Prostate Hyperplasia

READERS: You’ve heard it before: Exercise, eat right, don’t smoke, maintain a healthy weight and limit alcohol, red meats, salt and fatty foods.

Here’s another reason to follow through. A new study lead by Mayo Clinic involving 30,000 post-menopausal women showed that those with a healthy diet and lifestyle likely reduced the risk of getting cancer and dying from it.

The study found that women who followed one or none of nine healthy living guidelines had a 35 percent higher risk of developing cancer than women who practiced at least six of the healthy habits. Researchers think results of the study, which followed women for 13 years, would be similar for men and younger adults.
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Additional Resources:
Treatment of Cancer
Appointment Information
Information on Reducing the Risk of Cancer

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.