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| TREATMENT FOR AN ENLARGED PROSTATE |
The assortment of treatment options for benign prostatic hyperplasia (aka: benign prostatic hypertrophy, or "BPH") can seem pretty confusing – so your fist step should be a visit with Dr. Kasabian.
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Even though there are a number of pharmaceutical answers to benign prostatic hyperplasia, urologists have increasingly looked to laser-reliant treatments as the next generation of minimally invasive answers to enlarged prostate issues. GreenLight and or Holmium Laser treatment are a notable improvement on the “gold-standard” surgical option (Trans-Uretheral Resection of the Prostate or TURP) because patients tend to experience fewer post-operative symptoms and may be able to go home sooner.
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Unlike most open surgical treatment options and certain minimally invasive procedures which may result in lengthy recovery periods, discomfort or swelling, laser-reliant solutions immediately ablate enlarged prostate tissues. They leave behind an open urination channel. Some patients require a short catheterization, others none at all. And, urologists are often able to treat GreenLight PVP patients on an outpatient basis, sending them home within twenty-four hours.
Treatment Options For BPH (an Enlarged Prostate) Include:
- Watchful waiting
- Medication in the form of 5-alpha-reductase inhibitors or alpha-blockers.
- Indigo also known as Interstitial Laser Coagulation.
- There are a variety of non-invasive surgical techniques that can be used to treat Benign Prostatic Hyperplasia—including Microwave Therapy (TUMT, CoreTherm, Prolieve and TherMatrix), Thermotherapy (AquaTherm), Needle Ablation (TUNA) or Photoselective Vaporization (PVP).
Laser Prostatectomy
Not so long ago, attacking enlarged prostate related urinary problems typically involved an invasive surgical procedure known as Trans-Uretheral Resection of the Prostate (TURP). These days, there’s a state-of-the-art, minimally invasive techniques that fall’s under the generic banner of Laser Prostatectomy.
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Dr. Kasabian is an expert in peforming all Laser Prostatectomy procedures:
- GreenLight Laser PVP – Photoselective Vaporization of the Prostate
- HoLAP - Holmium Laser Ablation of the Prostate
- Revolix Laser Prostatectomy
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Back in 1992, the various procedures that fell under the banner of laser prostatectomy first became available in general practice to treat symptoms related to the non-cancerous growth of the prostate known as BPH or benign prostate hyperplasia. The unique properties of laser light – which is to say the ability of laser energy to shape tissues without the need for mechanical contact or manipulation as well minimize the bleeding that once occurred during surgical procedures – has made its use the preferred option for any surgical candidate.
The Neodymium: YAG Laser (KTP Laser) has been used to perform laser prostatectomies. Its use allows urologists to safely remove excess prostate tissue with a procedure that results in little or no bleeding and few if any negative physiologic effects. The Neodymium: YAG (KTP Laser) produces a general coagulation (burning) of treated prostate tissues. The tissue dies, dissolves and later passes via the urinary stream, thereby easing urination symptoms, by creating a wider opening for the urine to pass through the patient’s prostate.
Frequency Doubled Q-Switched KTP Laser surgery has been widely studied, and has been proven to be a safe and effective answer to the symptoms of benign prostate hyperplasia. Both early and later complications associated with laser prostatectomy are considerably lower than those reported after traditional, surgical, prostatectomies. Further, the relative ease and safety of laser-reliant minimally invasive procedures allows them to be performed in an outpatient setting – a significant improvement on the open surgical procedure that called for a two to three day hospitalization.
Holmium Laser Ablation of the Prostate
Newer developments in laser-reliant surgical technology and minimally invasive operative techniques have produced another variant of the laser prostatectomy known as Holmium Laser Ablation of the Prostate or HoLAP. Based on a new laser wavelength - the Holmium laser. HoLAP offers urologists the advantage of certain physical properties and assets previously unavailable from the surgical lasers used to treat benign prostate hyperplasia.
Put simply, the Holmium Laser Procedure (HoLAP) vaporizes then cuts through enlarged prostate tissues without resulting in the burn injuries that sometimes occur with older lasers. In Holmium Laser Ablation of the Prostate, the Holmium laser is employed to precisely cut out the enlarged central portion of the prostate gland—the obstruction in the opening of the bladder in men suffering from BPH.
In terms of virtues, the control of bleeding and overall operative safety levels encountered by benign prostate hyperplasia patients during Holmium Laser Ablation of the Prostate are essentially identical to those encountered during earlier variants of laser prostatectomy.
The HoLAP Laser Procedure
During the HoLAP procedure, a thin fiber is inserted into a patient’s urethra via a cystoscope. The fiber then delivers Holmium laser energy that rapidly vaporizes and accurately removes enlarged prostate tissues. The urologist will be able to view and safely control the treatment area, tailoring it to a patient’s specific anatomy or needs. Depending on the exact technique the prostate gland is either wholly vaporized or sliced into small pieces that are later removed via the cystoscope.
Patients typically experience a dramatic improvement in their urine flow rate and long-lasting symptom relief. Laser Prostatectomy is generally performed in an ambulatory surgery center, hospital or clinic. Most patients are released after only a few hours or after an overnight stay. There has been a very high patient satisfaction rate. Often patients don’t even need a catheter – and if a catheter is required it’s usually removed in 24 hours or less.
GreenLight Laser PVP – Photoselective Vaporization of the Prostate
One of the newest and most effective treatment options for patients who’ve been diagnosed with benign prostatic hyperplasia is GreenLight Laser PVP. The PVP (Photoselective Vaporization of the Prostate) treatment offers a unique and simple solution to enlarged prostate symptoms. The GreenLight Laser System is minimally invasive treatment, it uses a high-powered green-light laser to vaporize and accurately remove enlarged prostate tissues.
 | | During the PVP procedure, your urologist will insert a thin fiber into your urethra via an instrument known as a cystoscope—that will allow your urologist to closely examine your bladder and your prostate. The fiber will deliver green-light laser burst that will vaporize and eradicate enlarged prostate tissues. Because of the cystoscope, your urologist will be able to view and safely control the treatment area, tailoring the treatment to the particular contours of your anatomy.
Since enlarged tissues are vaporized and removed, PVP creates a wide-open channel. Natural urine flow is restored immediately and adverse urinary symptoms swiftly relieved. |
GreenLight Laser PVP may be the best solution for patients suffering from incontinence or other problematic urinary symptoms. Patients can often be sent home only a few hours after the PVP procedure and most of them are able to resume a normal, but non-strenuous, activity level in just days. Of course, individual results can vary – so, you will need to consult your urologist for detailed information.
To learn more about the procedures or to schedule the appointment Dr. Kasabian
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Nabet G. Kasabian, MD, FACS
103 East 80th Street (at Park Avenue)
New York, NY 10075
Tel: 212-535-0755
Fax: 212-744-4539
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