Why do you recommend TUMT for the treatment of BPH with selected patients?

It is effective, minimally invasive; patients are requesting it with increasing frequency; and the reimbursement is fair. Importantly, TUMT allows urologists to successfully treat BPH in the physician office setting.

In the past, some urologists were reluctant to embrace TUMT due to their doubts about its safety and effectiveness, as well as the need for IV sedation. Today, oral sedation is sufficient, results are durable and manufacturers have addressed relevant safety concerns. Advancements in TUMT have also improved patient comfort during the procedure and reduced treatment times to approximately 30 minutes.

With the aid of a qualified technologist and proctoring in advance, TUMT is relatively easy to perform. Experience demonstrates that it is critical when evaluating prospective candidates for TUMT to adhere closely to the published patient selection criteria (size of gland, length of prostatic urethra, etc.). TUMT is ideal for many younger BPH patients because it preserves bladder neck function and, for this reason, is one of the least sexually disruptive treatments available.

Why should urologists consider PVP as another effective BPH treatment?

Some background is necessary to put this question in perspective and provide a complete picture. Urologists define a Transurethral Resection of the Prostate (TURP) as the 'gold standard' for the surgical treatment of BPH. In turn, this endoscopic procedure historically defined the practice of urology. TURP reached its peak in the mid-1980s when physicians annually performed approximately 500,000 of these operations. Since then, that figure has declined dramatically to about 200,000 per year.

Meanwhile, over the past 15 years, many in the medical community have also embraced drug therapies or watchful waiting as popular, non-surgical standards of care for BPH patients. One consequence of using drugs and prolonged monitoring to delay surgery is that more BPH sufferers will present to the urologist exhibiting advanced prostatism. These individuals will require surgical therapy. For patients who display a dramatic increase in residual urine, the choice for definitively relieving obstruction will become one between TURP or PVP.

Photoselective Vaporization of the Prostate (PVP) or laser treatment of BPH using the GreenLight PV surgical laser system (an 80-watt KTP laser) offers BPH patients a meaningful alternative to TURP. A significant advantage of PVP compared to TURP is the lack of intra-operative and post-operative bleeding. In addition, laser surgery usually requires no post-operative irrigation. PVP patients require post-operative catheterization for a short duration of generally less than 24 hours after laser surgery.

When combined, these characteristics of the GreenLight Laser System offer the patient a shorter post-operative recovery period, quicker healing and a speedier return to normal activities than does TURP.

Urologists can now offer BPH patients this unique form of laser therapy in an outpatient setting. Operating time is less than or equivalent to TURP. Most importantly, clinical results to date are as good as TURP in improving Uroflow Rates and AUA Symptom scores.