Laser Treatment Helps Men Battle Elarged Prostate

By Kay Jones
Reproduced from Kenosha News

New powerful laser technology that vaporizes benign enlarged prostate tissue is promising quality of life to men who otherwise face decades of medication, at best, or a painful surgical procedure with a long recover period.

The new procedure, called the Niagara PV Laser System, has been used since April by Drs. Ned Novsam and Meredth Clubb, of Kenosha Urology Clinic. They are the only urologists in Wisconsin to date to offer the newly FDA-approved technology.

Urinary problems caused by enlarged prostate are a fact of life for most American men, sooner or latter, said Novsam.

Although the cause is not well understood, more than half of men more than 60 develop an enlarged prostate, which exerts pressure on the urinary tract making urination progressively difficult and sometimes painful.

By age 80, nearly 80 percent of all men have this condition.

The prostate gland is a walnut-size gland that is part of the male reproductive system. It is made up of two lobes and located just below the bladder and surrounds the urethra, the canal through which urine passes out of the body.

When it becomes enlarged, it presses against the urethra and irritates the bladder, causing the symptoms that are so common among older men.

The new procedure uses a powerful, 80 watt laser to vaporize the tissue causing symptoms. The laser it uses has been around since the 1980s, but the procedure was invented at the Mayo Clinic in 1997, according to its developers.

It is done as an outpatient procedure and takes about 30 minutes. It is basically bloodless and offers immediate relief from symptoms. Patients can return to work in one to two weeks, Novsam said.

It has been very well received by patients in his practice, he said.

A laser on the tip of a thin wand is inserted into the urinary canal. The physician watching a video monitor showing the area being treated directs the laser beam to the enlarged tissue.

The laser literally vaporizes the tissue, leaving the canal clear.

Although many men traditionally have chosen to treat the condition with medication as long as possible, the "gold standard of treatment until now has been transurethral resection," Novsam said.

In that procedure, which is done under general anesthesia, the surgeon works through a 12-inch scope inserted in the urinary canal.

An electrical loop in the scope is used to cut out the obstructive tissue one piece at a time. The area is then flushed through the bladder.

Although effective, Novsam said, that procedure involves significant bleeding, a three-day hospital stay and a four to six week recover period. Side effects can include intermittent blood in the urine and a burning sensation and sexual function is sometimes affected.

Medication too can have side effects, Novsam said.

"In some men it causes dizziness, a drop in blood pressure and some have a stuffy nose," he said. And it is a lifelong problem so it can get expensive.

Enlarged prostate can also be treated with microwave technology, in which the microwave energy delivered through a probe is used to burn out the excess tissue.

"That leaves the burned tissue there to die and the body sloughs the dead tissue off," Novsam explained. "While that is happening, the symptoms are worse and you have a longer, slower recover."

Novsam said lasers have been tried in the past, but they lacked the power that the new technology offers and the results were not so good.

"With some of the other laser procedures, it took six to 12 weeks to see improvement," he said. "The new, powerful laser heats so rapidly the tissue is vaporize and there is no dead tissue to slough off."

Novsam said that in the four years the laser has been tested, virtually no side effects have been observed.

Clinic Offers New Treatment for Prostate Enlargement: Laser Treatment Fast, Effective

Reproduced from The Journal Times, Wednesday, July 24, 2002

KENOSHA - Patients in southeastern Wisconsin who suffer from urinary problems causes by prostate enlargement or benign prostatic hyperplasia have a new treatment option. The Kenosha Urology Clinic is the first group in the state to use the Niagara PV Laser System.

This new treatment employs a powerful KTP laser system, recently approved by the Food and Drug Administration to remove prostatic obstruction in a short procedure with rapid recovery. The treatment offers compelling advantages relative to other therapies.

More than half of men over age 60 develop an enlarged prostate. By age 80, nearly 80 percent of all men have this condition. Symptoms of benign prostatic hyperplasia, or BPH, include difficulty in urination, reduced flow rate, frequent urination (especially at night), and incomplete urination with leaking and burning and other discomfort while urinating.

In the past, people suffering from BPH had three main treatment options: medication, if the condition was caught in its early stages; one of the various thermal technologies designed to shrink obstructing tissue, such as radiofrequency heated needles or microwave probes; or transurethral resection of the prostate.

Medication can improve the symptoms of BPH, but this treatment requires daily dosing for life with expensive drugs that can have significant side effects.

Microwave and radiofrequency therapy offer solutions to men on an inconsistent basis, may require long-term catheter drainage, and often take six to 12 weeks to be effective.

Transurethral resection of the prostate or TURP, has been the "gold standard" for treating BPH, but this method requires an in-hospital stay of several days with potential side effects and complications including bleeding, incontinence and impotence. Patients require a catheter for tow to four days and a month to recover fully.

The new procedure conducted with the Niagara PV laser can be performed on an outpatient basis with light general or short spinal anesthesia. It causes negligible blood loss, is relatively painless and has an extremely quick recovery period with excellent results.

Niagara PV laser treatment works by completely vaporizing the excess prostate tissue quickly, immediately sealing the surrounding tissue to minimize any bleeding. The benefit of immediate vaporization is that there is no tissue left behind to slough out, as there is with microwave and radiofrequency procedures.

The procedure is fast (about 30 minutes) and effective. The patient goes home in a few hours without a catheter or with one that is removed the next morning at home. Flow rates, improvement in symptoms, and patient satisfaction exceed the norms for all other procedures. Most patients can resume all activities within two weeks.

The procedure has been studies by Dr. Reza Malek at the Mayo Clinic for the last four years and has been shown to have unmatched clinical results, durability, safety and patient satisfaction.

Drs. Novsam and Clubb at the Kenosha Urology Clinic feel this treatment is a definite breakthrough. Patients have a simple 30-minute laser procedure, which is minimally invasive, highly effective and has very few risks.

To see the video of the procedure, go to www.laserscope.com.

For more information, call the Kenosha Urology Clinic at (262) 656-8213.