Treatments for an Enlarged Prostate Video

his health video will focus on the wide array of treatments traditional or non for enlarged prostate or BPH (Benign Prostatic Hyperplasia).
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Dr. Edward J. Mueller: The GreenLight Photoselective Vaporization of the Prostate is the newest laser treatment out there that can provide relief of symptoms very comparable to a TURP, with minimal side-effects and minimal hospitalization. Dr. Barry Stein: I would say, it's like taking a hot knife through butter and the prostate just really, literally melts in front on you. Because it's done under fluid medium, we don't really see smoke per se, what it looks like is tissues just melting in front of you. And that's used to, if you will melt the tissue away, without bleeding and some of the other issues that we see, when you do a TURP procedure. Dr. Edward J. Mueller: We use a 532 nanometer wavelength laser to actually vaporize the tissue and create a wide open prostate just like with a TURP, but without any other side-effects you get with a TURP, because the high heat from the laser actually coagulates the little vessels, you get very little bleeding with it and you end up with a wide open prostatic fossa. Dr. Barry Stein: We know from many studies in the past that the prostate grows at about 4%-5% per year, and if you are not doing a surgical procedure that removes tissue, now the prostate may still continue to grow but it's going to be smaller when we are done and it's going to take a while to get back to where we were. But if you do something that doesn't remove tissue, the next year it's 4% or 5% bigger than it was the year you did your procedure and I would say that you have to apply the theory of compound interest, when you look at that. So, it's not just 4%-5% but it's 4%-5% on the extra 4%-5% and this goes on every single year of a man's life. So, the prostate after a Microwave or TUNA is getting bigger every year immediately, whereas with a laser, a GreenLight Laser or a TURP, we have really set the scale back, because we've let's say, halved the size of the prostate or possibly more. And now, it will take a good number of years till we even get back to where we were, let alone, get to be bigger than where we were. So, the failure rates run a couple of percent per year, and the other procedures, you can say that after and you can argue about the exact number, but after 4 or 5 years, something between 25%-50% of men have failed with TUNA or Microwave. But now you take GreenLight Laser or a TURP and after 4 or 5 years something like 5%-10% have failed. They need something more to be done or repeat treatment. So, there is a big difference between 25%-50% recurrence rates and 5%-10% recurrence rates. Dr. Edward J. Mueller: The three main side-effects that you see are hematuria. You may see a little blood right at the beginning of the stream for a few days afterwards. An urgency and frequency of urination, because you have got a raw surface in their and urine is usually a little acidic, this raw surface has this necrotic realm of 2 mm around it and you are urine can irritate it, which can give you the sensation like you have to urinate. And so, until that really heals over, some patients have a lot of urgency and frequency, but it's transient, it will go away. Dr. Barry Stein: Because we are not creating any bleeding, the patient has no chance of needing a transfusion. It can be done in patient who are on blood thinners, I have to do one next week, we can't stop them. You would never do that with a typical TURP. It's outpatient, patients all go home the same day and somewhat over half of them go home without even catheter. So, it's really much easier in that way, because there is no bleeding, they get back to work and normal activities quicker. So, that's what helps to make it a quicker recovery, is the lack bleeding issues. Dr. Edward J. Mueller: It's tremendously better. PVP, what I tell my patients is, take it easy for 48 hours and as long as you don't have any bleeding, you always get a little oozing after the procedure, it's like if you scrape your knee, it's what I always tell my patients. It's like you scrape y

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