Experience the Innovative Therapy for Benign Prostate Enlargement A Guide to Treatment of Benign Prostatic Hyperplasia
1. 2. The Prostate The prostate gland is a part of the male reproductive system. A normal prostate is the size of a chestnut and weighs about 20 grams. It is situated below the urinary bladder and surrounds parts of the urethra (the tube that carries urine from the bladder). As a male gonad it produces most of the seminal fluid. Prostate Residual urine When a man is in his 30s, the prostate begins to enlarge as a natural process of aging. In some men, the increase in volume causes urination problems. Doctors refer to this condition as benign (non-cancerous) prostatic hyperplasia (BPH) or benign prostatic syndrome (BPS). Not all men who have an enlarged prostate experience symptoms. Yet if the prostate gland begins to expand substantially, it presses on the urethra and thus narrows it. This leads to the typical voiding disorders (see Fig. 1). Today, many men suffer from the symptoms of benign prostatic hyperplasia. The number increases with age: about 30 per cent of men over 50, 40 per cent of men over 60 and even 50 per cent of those over the age of 70 suffer from the effects of an enlarged prostate gland. 3. Fig. 1: Anatomy of a healthy and an enlarged prostate gland. The arrows symbolize the pressure on the urethra. Benign Prostatic Hyperplasia (BPH) The Symptoms Benign prostatic hyperplasia manifests a variety of symptoms that differ from patient to patient. The narrowing of the urethra causes various urination problems such as a weak urine stream, dribbling after urination, feeling that the bladder is not completely empty or the need to pass urine frequently at night. Sometimes these symptoms can reduce the quality of life to such a great extent that those affected build their daily routines around the condition. They avoid drinking or plan their errands around easy access to toilet facilities. When this state is reached, an effective therapy is highly mandatory. If benign prostatic hyperplasia is not treated, it holds considerable risks. Without treatment it can lead to complications such as severe urinary tract infections, urinary retention or even renal failure.
4. The Therapy BPH therapy aims at reducing the patients symptoms and at increasing their quality of life. Moderate symptoms can usually be treated successfully with medication. Surgery becomes necessary in cases where the medication is either not effective, not well tolerated or if there are severe complications. Ultimately, three out of ten men suffering from benign prostatic hyperplasia have to undergo surgery. One has to point out, however, that surgery constitutes the most effective treatment option, as it directly targets the cause of the disorder. The enlarged tissue is surgically removed and the urethra is thus relieved from the pressure. Today, doctors can choose from a variety of safe and efficient minimally invasive surgical options by which the prostatic tissue is removed through the penis via the urethra (transurethral). The so-called transurethral resection of the prostate (TUR-P) represents the standard procedure, and has been performed in most cases so far. TUR-P is usually performed under general or spinal anaesthesia. The surgeon reaches the prostate by inserting a thin, tube-like instrument (a resectoscope) through the urethra. An optic light source and a very small camera in the tube allow the surgeon to see a magnified view of the operative field. A wire loop electrode at the top of the resectoscope is passed along the prostatic tissue and cuts away the obstructing tissue one piece at a time. Thus, the prostate is virtually shelled out from the inside and symptoms are reduced effectively. Despite the gentle, minimally invasive treatment, there is a chance of side effects such as bleeding or tissue irritation. 5. TURis Plasma Vaporization New and More Gentle Prostate TURis plasma vaporization is a completely new surgical option that is now available to doctors for the treatment of benign prostatic hyperplasia. It constitutes an innovative development of TUR-P in which prostate tissue is removed with greater safety, and even more gently. 2 1 Resectoscope 3 Cut-off tissue Wire loop electrode As opposed to the conventional transurethral resection of the prostate (TUR-P), this new procedure does not cut and shave off tissue with a loop but energetically vaporizes the tissue with a small electrode. Gained space Fig. 2: Conventional TUR-P: obstructive tissue is cut off with wire loop electrode.
With the help of the latest plasma technology, a plasma field is created that coats the half-spherical electrode and whose concentrated energy is released onto the tissue, thus vaporizing it. The surgeon can remove the cells safely and gently by gliding the electrode over the prostate tissue. There is practically no direct contact needed between treatment option. That is to say, even though the tissue is removed more gently, the disorders can be relieved just as well and permanently as with the present standard procedure (TUR-P). Plasma vaporization thus represents the innovative surgical treatment option that can remove the cause of BPH safely and yet with high efficiency. CONVENTIONAL NEW Fig. 4: Comparison of ablation instruments (resection loop vs. TURis plasma vaporization electrode). Fig. 3: The new electrode gliding over the tissue, removing it without cutting. electrode and tissue. In contrast to other modern surgical treatments that operate with energy, no healthy tissue is injured or irritated in plasma vaporization. Complications following surgery can thus be avoided. This modern plasma vaporization does not only vaporize the tissue, it also coagulates (heat seals) its surface and leaves behind a smooth tissue surface. Bleeding during and after surgery can be avoided from the start, and a quick healthy healing of the wound is stimulated. Plasma vaporization constitutes a novel procedure that now provides the patient with the maximum degree of safety while being as effective as the current standard 6. After Plasma Vaporization Quick Recovery The high degree of safety during the smooth procedure has an impact on the recovery time after surgery. The catheter that is routinely inserted through the urethra after prostate surgery can usually be removed 24 hours following plasma vaporization since it produces only minimal lesions. In other procedures, however, the catheter is most often left in place for several days. The healing process is accelerated by the particularly gentle procedure, and usually the urinary tract will function properly shortly after surgery. Very often, the patient will be able to leave the hospital the day following surgery and return to his everyday life.
This brochure provides the latest information about the condition and the treatment of non-cancerous prostate enlargement. Learn all about the novel and particularly gentle surgical procedure offered by Olympus: TURis plasma vaporization. With the help of the latest plasma technology, prostate tissue can be removed with unparalleled protection of the patient. Surgical procedures always involve some risks. Different levels of risks are associated with different procedures. Before signing the consent form, make sure the doctor explains all risks. W7.074.360 1.0_03/09