By Emily Berry
Staff Writer
A new type of surgery using a green laser beam is giving aging men a less painful and simpler solution to a problem almost all will face, surgeons said.
Nearly three out of four men age 70 and older have an enlarged prostate, which can mean frequent trips to the restroom.
New, heavily advertised drugs such as Flomax and Uroxatral are a common treatment for the problem. But for men for whom drug treatment doesn't work or stops working, surgery to make the prostate smaller is a more permanent solution, said Dr. David Horger, a urologist with Academic Urologists at Erlanger hospital.
Dr. Stephen Jackson, a urologist with Tennessee Valley Urology Center in Cleveland, said the aging population of baby boomers likely will drive up demand for the green light laser procedure and other urological surgeries.
A surgery called transurethral resection of the prostate, known as TURP, once was the standard treatment for enlarged prostate. According to the Centers for Disease Control and Prevention, TURP once was the second most common surgery in the United States after cataract surgery, but drug therapy since the 1990s has reduced the number of surgeries done to treat the condition.
Compared to removing part of the prostate by using a wire with an electrical current, as in a TURP surgery, the green light laser procedure causes less bleeding and has a much shorter recovery time, Dr. Horger said. The laser emits a wavelength that vaporizes cells, cutting down tissue without triggering bleeding, while the TURP surgery involves slicing through prostate tissue "like butter" and causes sometimes profuse bleeding, he said.
"(TURP) took a lot more time and was costly for everyone involved," Dr. Horger said.
Jesse Fowler, 58, said he and his doctors believed he was having a stroke last fall, but they discovered the source of his symptoms was urological -- his kidneys and bladder weren't functioning correctly, and part of the problem was his difficulty urinating. To his surprise, after undergoing a prostate reduction at Erlanger hospital using a green light laser, both his urinary symptoms and the lower back pain he'd been having disappeared.
"I'm well-pleased with it," he said. "They go in and put you to sleep, and a couple of hours later you're up and walking out."
Dr. Jackson said the green light laser procedure takes around a half hour, and a patient can go home the same day, usually with a catheter than can be removed the next day, he said.
In comparison, after a TURP surgery, a patient has to use a catheter for two or three days, said Dr. Jackson.
The lower risk of bleeding with the green light procedure also means that men taking blood thinners don't have to go off their medications, which could put them at risk of stroke or blood clot, he said. He said he performs the green light procedure at both SkyRidge Medical Center campuses.
"The big advantage is it's basically a blood-free procedure," he said.
Dr. Horger said some men who live a long time may need treatment more than once -- with either a TURP or green light procedure, as the prostate can regrow and require another reduction within five to 10 years.
E-mail Emily Berry at eberry@timesfreepress.com
WHAT IS BPH?
Symptoms of benign prostatic hyperplasia, also called enlarged prostate, include frequent urination, trouble urinating, incomplete emptying of the bladder and decreased urinary stream. American men spent about $194 million annually on prescription drugs to treat BPH between 1996 and 1998.
Source: U.S. Centers for Disease Control and Prevention
Staff Photo by John Rawlston
Dr. David Horger, a urologist, performs prostate reduction surgery using a laser at Erlanger hospital.
