Minimally Invasive Prostate Surgery

Because drug treatment is not effective in all cases, researchers in recent years have developed a number of procedures that relieve BPH symptoms but are less invasive than conventional surgery.

Minimally Invasive Laser Technology

Minimally invasive surgical therapies for prostate enlargement offer an attractive option for men that don’t respond to medical therapies or that don’t want to take medications for the rest of their lives. Drs. McClure and McRackan specialize in a procedure called GreenLight Laser Therapy of the prostate. They utilize a Laserscope Greenlight HPS (high performance system) Niagra Laser. The GreenLight PV or PVP (Photo-Selective Vaporization of the Prostate) is a minimally invasive alternative to traditional transurethral surgery. Performed under sedation as an outpatient procedure, the entire surgery takes about 45 minutes. A tiny quartz fiber is inserted through a small scope that is inserted into the penis under direct vision. Laser energy within the green light spectrum is used to vaporize a wide channel within the prostatic urethra. The body sloughs the vaporized tissue over the next several months, which is replaced by a healthy new urethral lining. Men are either discharged the same day or the following morning without a catheter. Side effects are minimal. The majority of men experience a rapid and significant improvement in their voiding symptoms and quality of life.

green light laser Click here for further information about GreenLight Laser Therapy for prostate enlargement and to view an informative video about GreenLight Laser Therapy.

Transurethral microwave procedures

In May 1996, FDA approved the Prostatron, a device that uses microwaves to heat and destroy excess prostate tissue. In the procedure called transurethral microwave thermotherapy (TUMT), the Prostatron sends computer-regulated microwaves through a catheter to heat selected portions of the prostate to at least 111 degrees Fahrenheit. A cooling system protects the urinary tract during the procedure.

A similar microwave device, the Targis System, received FDA approval in September 1997. Like the Prostatron, the Targis System delivers microwaves to destroy selected portions of the prostate and uses a cooling system to protect the urethra. A heat-sensing device inserted in the rectum helps monitor the therapy.

Both procedures take about 1 hour and can be performed on an outpatient basis without general anesthesia. Neither procedure has been reported to lead to impotence or incontinence.

Although microwave therapy does not cure BPH, it reduces urinary frequency, urgency, straining, and intermittent flow. It does not correct the problem of incomplete emptying of the bladder. Ongoing research will determine any long-term effects of microwave therapy and who might benefit most from this therapy.

Transurethral needle ablation

In October 1996, FDA approved Vidamed's minimally invasive Transurethral Needle Ablation (TUNA) System for the treatment of BPH.

The TUNA System delivers low-level radiofrequency energy through twin needles to burn away a well-defined region of the enlarged prostate. Shields protect the urethra from heat damage. The TUNA System improves urine flow and relieves symptoms with fewer side effects when compared with transurethral resection of the prostate (TURP). No incontinence or impotence has been observed.

Hope Through Research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) was established by Congress in 1950 as one of the National Institutes of Health (NIH), whose mission is to improve human health through biomedical research. NIH is the research branch of the U.S. Department of Health and Human Services.

NIDDK conducts and supports a variety of research in diseases of the kidney and urinary tract. Much of the research targets disorders of the lower urinary tract, including BPH, urinary tract infection, interstitial cystitis, urinary obstruction, prostatitis, and urinary stones. The knowledge gained from these studies is advancing scientific understanding of why BPH develops and may lead to improved methods of diagnosing and treating prostate enlargement. One such study was the MTOPS Trial, which recently ended. The results are summarized above under Drug Treatment.

The Minimally Invasive Surgical Therapies (MIST) treatment group is looking at TUMT, TUNA, and other transurethral treatments for BPH that do not require a hospital stay.

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