Issue link: https://tmcpulse.uberflip.com/i/778575
t m c » p u l s e | j a n / f e b 2 0 1 7 40 T he prostate is a walnut-sized gland in the male reproductive system that is needed for fertility. It secretes a fluid that forms part of the seminal fluid, which carries sperm. As men age, the prostate gland often becomes enlarged, causing a host of problems. Over time, an enlarged prostate, known as benign prostate hyperplasia, can lead to difficulty with urination, urinary tract infections, blad- der stones, incontinence and damage to the bladder and kidneys. Though the cause of enlarged pros- tate is unknown, it is quite prevalent. Fifty percent of men over the age of 50 experience an enlarged pros- tate, said Steven Maislos, M.D., who specializes in urology at Baylor St. Luke's Medical Group. Typical treatments include life- style and behavior changes—such as reducing the intake of liquids and timed voiding—and medication. When none of these options works, doctors recommend minimally invasive procedures including transurethral nee- dle ablation (which uses heat to destroy prostate tissue) or surgery (a transure- thral resection of the prostate to remove tissue, or a transurethral incision of the prostate to widen the urethra). Holmium laser micro-enucleation for an enlarged prostate is a technique that is gaining exposure, and one that Maislos has introduced to St. Luke's. A new, 120-watt holmium laser uses concentrated, high-energy waves and intense heat to destroy prostate gland tissue that obstructs the flow of urine or causes other complications. "One is able to remove the tissue in the middle, and the benefit is much less bleeding than with the other methods," Maislos said. In addition to reduced bleeding, the 120-watt holmium laser offers patients a shorter recovery time and fewer com- plications, he says. With traditional sur- gery, the patient typically needs to have a special three-way catheter inserted for 24 hours to rinse out the blood so it does not clot and block the flow of urine. With the new laser, that is usually unneces- sary because there is less bleeding. But there are risks with the new laser, including infection, a hardening of tissues, and retrograde ejacula- tion—when semen enters the bladder instead of emerging through the penis during orgasm. That last one, Maislos said, even happens to men who are just taking the medication. The 120-watt holmium laser can be used to eliminate other unwanted objects in the body, including kidney stones. Since few physicians are trained to use it for the prostate, Maislos is teaching other doctors this application. He uses the device at St. Luke's Sugar Land Hospital. The only other hospital with the device is the Michael E. DeBakey Veterans Affairs Medical Center. "You don't have to vaporize the whole tissue, just some of it, and that saves time," Maislos said. "I think we will see more and more of these new lasers in the future." Making small work of an enlarged prostate B y C h r i s t i n e H a l l Solutions: TMC Innovations Above left: The Lumenis Pulse 120H, a 120- watt holmium laser. Credit: Courtesy of CHI St. Luke's Health John P. McGovern Commons 6550 Bertner Avenue, Sixth Floor Houston, TX 77030 thirdcoasthouston.com | Located in the heart of the Texas Medical Center, ird Coast is a perfect spot for morning meetings or to grab a bite with friends before work. Stop in for pancakes, omelets, huevos rancheros and other breakfast favorites. Make a reservation today through OpenTable or by calling 713.749.0400. Breakfast is served Monday through Friday, 7 to 10:30 a.m.