Abstract:

Prevalence of symptomatic benign prostatic hypertophy (BPH) is 30% in the sixth decade of life and approaches 50% in the eighth decade of life. Comparable prevalence values are reported in Occidental and Oriental cultures, which suggests the disease susceprible to neither environmental nor cultural favoritism. "Prostatism" is the descriptive word for the BPH constellation of symptoms, which appear as a result of bladder outlets obstructed by an enlarged prostate. In traditional prostatism, prostate growth has a benign etiology. These urologie symptoms may be either irritative (difficulty postponing urination, frequent awakenings at night for urination), obstructive (weak stream, hesitancy), or both. In the context of so much morbidity associated with the BPH symptom complex, this disease is arguably the most bothersome disease for the elderly male. With improvements in healthcare, and with men having longer life expectancies, there is the appreciation of an expanded patient population. It has become possible to heat the prostate with radiofrequency energy (RF) to relieve symptoms associated with BPH using a heating technique called "transurethral needle ablation of the prostate" (TUNA). By both subjective and objective criteria, TUNA theraphy to the prostate for BPH compares favorably with traditional surgical treatment. Now the durability of the TUNA treatment is demonstrated beyond three years.

Authors:

Samuel E. Myrick, M.D. - Emory University School of Medicine; Muta Issa, M.D., F.A.C.S. - Emory University School of Medicine, Atlanta Veterans Affairs Medical Center, Atlanta, Ga.

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Abstract:

The morbidity and mortality associated with transurethral resection of the prostate (TURP), as therapy for benign prostatic hyperplasia (BPH), is the impetus for the urological community's search for alternative medical and surgical treatments for BPH. Interstitial Laser Coagulation of the Prostate (ILC) is a minimally invasive procedure usually performed to relieve symptomatic BPH, that is accomplished by directing laser energy into the gland via an implanted optical fiber using standard cystoscopic techniques. Treatment of adenomatous tissue with ILC reduces the size of the prostate and disrupts alpha-adrenergic nerve fibers.

Authors:

J. Chandler Williams, M.D., M.S. - Division of Urologic Surgery, University of Pittsburgh, Pa., Valley Urological Associates, Sewickley, Pa.

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