Transcript Document

Men’s Health Talk
Dr. Kenneth R Thomas, August 28, 2012
Background – Dr. Thomas
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Grew up in backwoods Mississippi
High school at MSMS
Chemical Engineering undergrad at MSU
Medical school at UMMC
Urology training at University of Virginia
Married with 4 children
In this community to serve
Men’s Health Talk
What should we cover?
• Erectile Dysfunction
• Incontinence
• Low Testosterone
• Difficulty Voiding
Men’s Health Talk
Contact Info
• 302 Hospital Road, Starkville MS 39759
• 662-615-3756
Satisfying Solutions
Erectile Restoration
Erectile Dysfunction (ED)
What is it?
• The inability to maintain an erection firm
enough to have sexual intercourse
How prevalent is it?
• 1 in 5 American men
1
• Over 30 million American men
2
• Over 150 million men worldwide
2
• Causes: 90% physical, 10% psychogenic
1. Selvin E, Burnett A, Platz E. Prevalence and risk factors for erectile dysfunction in the US. Am Jour of Med 2007(120) 151-157
2. Sun P, Seftel A, Swindle R, Ye W, Pohl G. The costs of caring for erectile dysfunction in a managed care setting: evidence from a
large national claims database. J Urol. 2005 Nov;174(5):1948-52
3. Mulligan T, Teitelman, J. Geriatric sexual dysfunction. Va Med Q. 1991 Spring;118(2):97-9
3
Main Physical Causes of ED4
Vascular
Diabetes
Medication
Medication
Vascular
Pelvic Surgery, Radiation
or Trauma
Neurological Causes
Endocrine Problems
Other
Diabetes
4. Goldstein I. Male sexual circuitry. Working Group for the study of central mechanisms in erectile dysfunction.
Sci Am., Aug 2000;283(2):70-75
Degree of ED by Age
5
Prevalence of ED by Age and Severity (%)
100%
80%
Severe
Moderate
60%
40%
20%
0%
5. Data on file at AMS; Dymedex Market Research
Mild or Mild/Moderate
Do you have to live with ED?
NO!
Nearly every man can be successfully treated.
Treatment Options
For Erectile Dysfunction
Oral Medications
• Not effective in approximately 30% of cases
• Work only in response to sexual stimulation
• Must take at least ½ hour to one hour before
anticipated sexual activity
• Viagra® can remain effective for up to 4 hours , Cialis®
can be effective up to 36 hours
• High fat meals can affect absorption of Viagra
• Estimated cost per pill: $15-$30
6
7,8
7
7
8
7
9A
VIAGRA® is a registered trademark of Pfizer Inc. CIALIS® is a registered trademark of Eli Lilly
and Company Corporation.
6. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PF, for the Sildenafil Study Group. Oral
sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998 May 14;338(20):1397-404
7. http://www.pfizer.com/files/products/uspi_viagra.pdf; downloaded 7/21/11
8. http://pi.lilly.com/us/cialis-pi.pdf; downloaded 7/21/11
9A. http://www.buyviagrapillsonline.com/; downloaded 3/3/11
Oral Medications
• Common side effects
7,8
• Headache, Facial Flushing, Stuffy Nose, Upset Stomach
• Some Cautions
• Cannot take with NITRATES
• Precautions with alpha-blockers; medications for high blood
pressure and for prostate problems
7,8
7,8
•Tell Your Doctor if You:
• Have ever had any heart problems, stroke or low or high blood
pressure
• Have ever had liver or kidney problems
7
7
7. http://www.pfizer.com/files/products/uspi_viagra.pdf; downloaded 7/21/11
8. http://pi.lilly.com/us/cialis-pi.pdf; downloaded 7/21/11
Vacuum Erection Device
10
Some Advantages
Some Disadvantages
• Non-invasive
• Cumbersome
• Drug free
• Unnatural erection
12
12
• Cost effective
• Erection is not warm to the touch
• Bruising/burst blood vessels
• Penile pain/discomfort
• Numbness
11
• Delayed ejaculation
11
9B. Levine L, Dimitrious R. Vacuum constriction and external erection devices in erectile dysfunction. Urologic Clinics of North America
2001 May (28) No. 2, 335-341
10. Yuan J., et al. Vacuum therapy in erectile dysfunction – science and clinical evidence. International Journal of Impotence Research.
2010; 12: 211-219
11. The Process of Care Consensus Panel. The process of care model for evaluation and treatment of erectile dysfunction. Int J Impot
Res. 1999;11:59-70. Position Paper
12. Miner M.M., Kuritzky L. Erectile Dysfunction: A sentinel marker for cardiovascular disease in primary care. Cleveland Clinic Journal of
Medicine. 2007 May; 74 (3); 30-37
11
9B, 11
12
Urethral Suppository: MUSE®
Some Advantages
• No needles or
injections
•
Erection within 10 to 15
minutes
13
Some Disadvantages
• Penile Pain & Burning
13
•
Inadequate penile ridigity
•
Must be refrigerated
•
Cost is approximately $25
per application
14
13
14
•
Patients with poor manual
dexterity/vision or
severe obesity may find
administration difficult
15
MUSE is a trademark of VIVUS, Inc.
13. http://www.muserx.net/res/pack_inserts_PFI_1.3.pdf downloaded 11/12/10
14. http://www.infertility-male.com/erectdys/muse.htm, downloaded 2/15/11
15. Shabsigh R, Lue T.F. A Clinician’s Guide to ED Management. MPR Urologist 2006; 76-77
Penile Injection Therapy
Some Advantages
Some Disadvantages
•
Effective
•
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On-set of erection within
5-20 minutes
17
Risk of erection lasting 4 hours or more
(priapism)
16
16
•
Possible bleeding at injection site
•
Possible pain at injection site
•
Requires training
•
Cavernosal fibrosis
•
Poor long-term tolerability
•
Fear of sticking needle in penis
16
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16. http://labeling.pfizer.com/ShowLabeling.aspx?id=589; downloaded 7/21/11
17. Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients
treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile
dysfunction in urology practice. J Urol Jul 2003 v.170(1)p.159-63
17
16
Penile Implants
Ideal for men who have tried other
treatments without success
• On the market for over 30 years
• Over 300,000 implants to date
18
• High patient and partner satisfaction
19,20
18. "Penile Prosthesis." The Sexual Medicine Web Site. 2008. European Society for Sexual Medicine. 23
Jan 2009 http://www.essm.org/patient-area/penileprosthesis.asp; downloaded 1/8/09
19. Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of, and patient satisfaction with
the Ambicor inflatable penile prosthesis: results of a 2 center study. J Urol. 2001 Sep;166(3):932-7
20. Montorsi F et al. AMS three-piece inflatable implants for erectile dysfunction; a long-term multiinstitution study in 200 consecutive patients. Eur Urol. 2000; 37:50-55
Penile Implant Versus Other Treatment Options
Overall Patient Satisfaction with ED Treatments
17
n=22
n=31
n=32
Percentage Satisfied
17. Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1
and penile implant surgery for erectile dysfunction in urology practice. J Urol Jul 2003 v.170(1)p.159-63
Three-Piece Inflatable Penile Implant
Some Advantages
• Totally concealed in body
• Device is inflated to provide rigidity
and deflated for concealment
• Erection longevity is controllable
• When deflated, the cylinders are soft and flaccid
• Expands in girth (all AMS 700® cylinders) and
length (AMS 700 LGX® and Ultrex® cylinders)
• AMS 700 with InhibiZone® is the only
inflatable penile prosthesis with clinical
evidence showing a significant reduction
in the rate of revision due to infection
Implants are Highly Recommended
These recommendations pertain to the AMS Two-piece inflatable prosthesis
19. Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of, and patient
satisfaction with the Ambicor inflatable penile prosthesis; results of a 2 center study. J Urol.
2001 Sep; 166 (3) :932-7
19
Benefits
• Offers a long-term solution to ED
• Provides the ability to have an erection
anytime you choose
• Allows for greater spontaneity – have sex when the
mood strikes
• Enables you to maintain an erection as long as you
desire
• Eliminates the need for costly pills or shots
• Feels natural during intercourse
• Does not interfere with ejaculation or orgasm
19
19. Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of, and patient satisfaction with
the Ambicor inflatable penile prosthesis; results of a 2 center study. J Urol. 2001 Sep; 166 (3) :932-7
Possible Risks
• Will make latent natural or spontaneous erections as well
as other interventional treatment options impossible
• If an infection occurs, the prosthesis may have to be
removed
• May cause the penis to become shorter, curved or
scarred
• There may be mechanical failures of the prosthesis
• Pain (typically associated with healing process)
As with any medical procedure, there are risks involved
and not all patients are candidates for a penile implant.
Discuss the risks and benefits of this procedure in more
detail with your urologist.
Insurance Coverage
• Is a penile implant covered by insurance
or Medicare?
Insurance Coverage
• Is a penile implant covered by insurance
or Medicare?
• YES!
– Most insurance carriers cover the cost of
implant surgery
Summary
• ED is a common problem
• Nearly every man can be successfully
treated for ED
• Penile implants offer a long-term solution
• Talk to your partner, talk to your Urologist
Brief Summary – AMS 700 and Ambicor
The AMS 700® Series Inflatable Penile Prosthesis and the AMS Ambicor®
Penile Prosthesis are intended for use in the treatment of chronic, organic,
male erectile dysfunction (impotence). These devices are contraindicated in
patients who have active urogenital infections or active skin infections in the
region of surgery or (for the AMS 700 with InhibiZone®) have a known
sensitivity or allergy to rifampin, minocycline, or other tetracyclines.
Implantation will make latent natural or spontaneous erections, as well as
other interventional treatment options, impossible. Men with diabetes, spinal
cord injuries or open sores may have an increased risk of infection. Failure
to evaluate and treat device erosion may result in infection and loss of
tissue. Implantation may result in penile shortening, curvature, or scarring.
Possible adverse events include, but are not limited to, urogenital pain
(usually associated with healing), urogenital edema, urogenital ecchymosis,
urogenital erythema, reservoir encapsulation, patient dissatisfaction, autoinflation, mechanical malfunction, impaired urination, penile curvature, or
sensation change.
Prior to using these devices, please review the Instructions for Use for a
complete listing of indications, contraindications, warnings, precautions and
potential adverse events. Rx Only
Questions on ED?
Satisfying Solutions
Understanding Male Continence
What is Incontinence?
Male urinary incontinence is usually
caused by a damaged sphincter, the
circular muscle that controls the flow
of urine out of the bladder.
When damaged, often the
unavoidable result of prostate
cancer surgery, the muscle cannot
squeeze and close off the urethra.
This causes urine to leak.
“My plumbing has a faulty washer”
Types of Incontinence
• Stress Urinary Incontinence (SUI)
Leakage during a physical activity like lifting, exercising, sneezing,
and coughing, most common following prostate cancer surgery.
• Urge Incontinence
Leakage associated with an overwhelming need to urinate…Gotta
go, gotta go!
• Overflow Incontinence
Leakage when your bladder never completely empties
• Total Incontinence
Leakage when the urinary sphincter muscle is completely deficient.
How Does the Process Work?
• In men, the urinary sphincter
muscle is located below the
prostate.
• The sphincter muscle surrounds
the urethra.
• When the sphincter muscle tightens,
it holds urine in the bladder.
• When it relaxes, the bladder
contracts and the urethra opens,
allowing urine to flow outside the
body.
• When the sphincter muscle is
damaged, it cannot close off the
urethra.
What Causes Incontinence?
• Prostate Cancer Surgery
(Radical Prostatectomy or TURP)
• Conditions such as diabetes, multiple sclerosis,
Parkinson’s disease or stroke
• Pelvic Trauma
• Birth Defects
Why Treat Incontinence?
150 men reported the practical inconveniences
associated with incontinence :
21
• 52%
• 37%
• 17%
• 12%
• 11%
Extra laundry
Smell
Extra expense
Skin irritation
Disturbed sleep
21. Hunskaar s, Sandvik H. one hundred and fifty men with urinary incontinence. Scand J Prim Health
Care 1993 v. 11 p.193-196
Am I the only one suffering from
Incontinence?
NO!
• Worldwide, 55 million men suffer from incontinence .
22
• 5 million men in the United States suffer from
incontinence .
22
• Rate of incontinence ranges between 2.5% up to 69%
after prostate surgery .
23
22. AMS Market Research on file
23. Tewari A. et al. Anatomic Restoration Technique of Continence Mechanism and Preservation of Puboprostatic Collar: A Novel Modification to Achieve Early Urinary Continence in Men
Undergoing Robotic Prostatectomy. Urology. 2007; 69(4): 726-731
Do you have to live with Incontinence?
NO!
Can you Live Life Dry?
YES!
Treatment Options for Stress Incontinence
Behavioral Modification and Medication
• Decrease fluid intake
• Urinate frequently
• Avoid caffeine, alcohol
• Avoid activity that increases
intra-abdominal pressure
• No FDA approved medication for stress
incontinence in men
Absorbent Products: Pads, Diapers
• Is this a satisfactory solution for you?
• Are these the best solution?
• How often are you changing them?
• Skin irritation and rashes
• Inconvenience
Absorbent Products: Pads, Diapers
• Cost is a factor…
Cost Comparison of Wearing 5 Pads a Day for 10 Years
Cost/10 years24
Entrust
Undergarments
$0.99 each
Active Style Pads
$0.52 each
Coveen Drip
Collectors
$1.05 each
Depends
Undergarments
$0.52 each
24. Brown J.A., Elliott D.S., Barrett D.M. Post prostatectomy Urinary Incontinence: A Comparison of the Cost of Conservative Versus Surgical
Management. Adult Urology. 1998; 51(5): 715-720
Devices: Clamps
25
Cunningham Clamp, C3-clamp
Some Advantages
•
•
•
•
Non-medical, non-surgical
Easy to use
Functional
Inexpensive
Some Disadvantages
• Scarring
• Pain
• Skin and tissue problems
25. http://www.prostate-cancer.com/coping-with-prostate-cancer/incontinence-penile-clamps.html; downloaded 1/7/10
Devices: Catheters
26
External vs. Internal
Some Advantages
• Functional
Some Disadvantages
• Urinary tract infection
• Damage to the penis from friction
with the condom
• Urethral blockage
26. http://www.prostate-cancer.com/coping-with-prostate-cancer/incontinence-condom-catheter.html, downloaded 11/17/10
Collagen Injections
• Collagen, carbon beads, autologous fat
• Success rates for collagen ~
17% after prostatectomy
27
27 Klingler HC et al. Incontinence after radical prostatectomy: surgical treatment options.
Curr Opin Urol 2006; 16:60-64
Surgical Options
• AdVance® Male Sling
• AMS 800® Urinary Control System
AdVance Male Sling: Benefits
• Outpatient surgery
• May be performed under
spinal or general anesthesia
• Often no catheter necessary
upon discharge
• No device activation required
• May begin to notice improvement
following procedure
28
• Restored dignity and quality of life
28. Rehder P., Gozzi C. Transobturator Sling Suspension for Male Urinary Incontinence Including PostRadical Prostatectomy. Eur Urol 2007
AdVance Male Sling System
AdVance is not for people with:
• Urinary tract infections
• Blood coagulation disorders
• Compromised immune systems or any other condition that would
compromise healing
• Renal insufficiency and urinary tract obstruction
For a complete list of risks associated with AdVance, refer to
device labeling at www.amselabeling.com.
Rx Only
AMS 800® Urinary Control System
Artificial Urinary Sphincter (AUS)
The Gold Standard for treatment of
incontinence
• The cuff wraps around the urethra
and is inflated/closed at rest
• Pump in the scrotum
deflates/opens sphincter
and allows urination
The next slide will illustrate how
this system works
AMS 800® Urinary Control System
Artificial Urinary Sphincter (AUS)
• Outpatient procedure
• Effectively gives most men the ability to achieve continence
• 91% of patients would have the device placed again
• 82% of patients would recommend it to a friend
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• Device is placed completely inside the body, providing simple,
discreet urinary control
• Published clinical data shows long-term effective results
29. B. Kahlon, et al. Quality of life and patient satisfaction after artificial urinary sphincter. Can Urol
Assoc J. Jan 2011: 1-5
AMS 800® Urinary Control System
Artificial Urinary Sphincter (AUS)
The AMS 800 is not for those men:
• Who are not good candidates for surgical procedures or anesthesia
• With an irreversibly blocked lower urinary tract
• With irresolvable detrusor hyperreflexia or bladder instability
• With a known allergy or sensitivity to rifampin, mimocycline or other
tetracyclines
• Who have challenges optimally using their hands
Rx Only
As with most surgical procedures, inherent risks are present and potential adverse
reactions may occur. Although rare, some of the most severe risks include
infection, erosion, and perforation. Some potential adverse reactions to surgical
procedures to correct incontinence include:
• Pain/Discomfort/Irritation
• Inflammation
• Incomplete correction of urinary incontinence
• Urinary Tract Infections/Obstruction/Retention
• Urge symptoms
• Difficulty with urination
You should talk to your doctor about the benefits and risks before moving forward
with any treatment option. For additional product and risk information visit:
www.AmericanMedicalSystems.com
Summary
• Incontinence is a common problem
• Some treatments are more effective than others
• Surgical treatment options offer proven,
long-term solutions
• Talk to your Urologist – talk to your partner
• You can Live
Life Dry!
Brief Summary – AMS AUS 800
The AMS Sphincter 800 Urinary Prosthesis device is intended to treat
urinary incontinence due to reduced outlet resistance (Intrinsic Sphincter
Deficiency). The device is contraindicated in patients who are determined
to be poor surgical candidates, have an irreversibly blocked lower urinary
tract, have irresolvable detrusor hyperreflexia or bladder instability, or
(for the AMS 800 with InhibiZone®) have a known sensitivity or allergy to
rifampin, minocycline or other tetracyclines. Patients with urinary tract
infections, diabetes, spinal cord injuries, open sores or regional skin
infections may have increased infection risk. Device-skin erosion may
occur. Proper patient evaluation, selection and counseling of realistic
expectations should occur. Possible adverse events include, but are not
limited to, compromised device function, pain/discomfort, delayed wound
healing, migration and recurrent incontinence.
Prior to using these devices, please review the Instructions for Use for a
complete listing of indications, contradictions, warnings, precautions and
potential adverse events. Rx Only
Questions on
Male Continence?
Low Testosterone
(Male Hypogonadism)
Low Testosterone (Low T)
What is it?
• Low testosterone (sometimes called “hypogonadism” or “low T”)
occurs when a man’s body produces less testosterone than is
normal
How many men are estimated to have Low T?
• Approximately 4 in 10 men over age 45 may have low testosterone
• The percentage rises as men get older
• Low testosterone is more common in men who are obese, type-2
diabetic, have high cholesterol or have high blood pressure than in
men without these conditions
Mulligan T et al. Int J Clin Pract. 2006;60(7):762-769.
Percentage of men with low testosterone
Percentage of Men with Low Testosterone
Rises as They Age
HIM Study: prevalence of hypogonadism in 2165 men > age 45 presenting to 95 primary care practices 1
60.0
50%
50.0
40.0
46%
39%
40%
40%
55–64
65–74
34%
30.0
20.0
10.0
0.0
Total
(45+)
1. Mulligan T et al. Int J Clin Pract. 2006;60(7):762-769.
45–54
Age Range, Years
75–84
85+
Want are Some of the Signs and Symptoms
of Low Testosterone?
What Can I Do if I Think I Have Low T?
• Low T is diagnosed based on symptoms you
may be experiencing, as well as testosterone
• Testosterone levels are determined via a simple
blood test. Depending on the results, your
healthcare professional may repeat the test.
• Talk to your doctor about your symptoms and
ask if a blood test to check your testosterone
levels is right for you.
Treatment Options
• If you are diagnosed with Low T, there are
available treatment options you can discuss with
your healthcare professional.
• Treatments currently include testosterone gels,
injections, and slow release testosterone pellets.
Understanding Prostate Health
Dr. Kenneth R Thomas, August 28, 2012
Overview of the Prostate and BPH
Overview of the Prostate
• Walnut sized gland at base of
the male bladder
• Surrounds the urethra
• Produces fluid that transports
sperm during ejaculation
Prostate Conditions
• Enlarged Prostate
• Prostatitis
• Prostate Cancer
Each condition affects the prostate differently
Aging and the Prostate
• BPH affects more than 26 million men
each year in the United States
• Prostate grows to a normal size in teenage
years and then begins to grow again around
the age of 50
• By age 60, half of all men have an enlarged prostate
• Affects most men by age 80
• Stress and diet are contributing to an increased
presence of enlarged prostate in younger men
What is BPH?
• Benign Prostatic Hyperplasia (BPH)
• Commonly known as enlarged prostate
• Non-cancerous enlargement of the
prostate gland
– BPH is not an indication or a predictor of cancer
– The opposite is also true – your PSA level is
not an indicator of BPH
Normal vs. Enlarged Prostate
• As the prostate enlarges,
pressure can be put on the urethra
• Causes urinary problems
Normal Prostate
• It is usually not life-threatening
In general, the size of the prostate does not
correlate to severity of symptoms
Enlarged Prostate
Recognizing the Symptoms of BPH
• Frequent urination
• Multiple trips to the bathroom at night
• Sudden urge to urinate
• Difficult or painful urination
• Weak or slow urine flow
• Incomplete elimination of urine
• Stopping and starting of flow
BPH Affects Quality of Life
• Many men who suffer from BPH
experience a reduction in quality of life.
– Avoiding travel
– Interruption of leisure activities
– Using the bathroom stalls instead of urinals
– Disruption of sleep patterns
How is an Enlarged Prostate Diagnosed?
• Medical History
• Physical Exam
• Symptoms – AUA Symptom Score
• Bothersome – How much of a bother is it to you?
Treatment Options
Treatment Options for Enlarged Prostate
• Watchful Waiting
• Medication
• Heat Therapy (TUMT)
• Laser Therapy
• Surgery (TURP)
Different treatments are
appropriate for different patients
Treatment Option
Watchful Waiting
Advantages
• No surgery
• No drugs
• No side effects
Disadvantages
• No improvements in symptoms
• Risk that symptoms will worsen
Treatment Option
Medication
Advantages
• No surgery
• Potential for
symptom relief
Disadvantages
• Must be taken daily
• Potential side effects
- Lowered sexual drive, erection problems,
nasal congestion and dizziness
• High out-of pocket cost
- Average daily cost
Flomax $3.28 ($1,197/yr)
Avodart $2.54 ($927/yr)
• Over time may stop working
Treatment Option
Transurethral Microwave Therapy (TUMT)
Advantages
•
•
•
•
Safe and effective
In-Office Procedure
Short procedure time
Can be performed with
only a mild oral sedative
Disadvantages
• Catheterization required
• Best for mild symptoms
• Variable levels of short and long term
functional improvements
Treatment Option
Surgery (TURP)
Transurethral Resection of the Prostate
Advantages
Disadvantages
• Proven approach
• Surgical procedure risks:
• Bleeding requiring transfusion
• Retrograde ejaculation rate: 53 - 75%
• ED rate of 6.3%
• Persistent incontinence
• General or regional anesthesia necessary
• Catheterization required
• Hospitalization required
• Activities after surgery restricted
for about 6 weeks
An Advanced Treatment Option
GreenLight Laser Therapy
• Over 375,000 patients treated worldwide
• Done in an outpatient setting and typically no overnight stay is required
• Provides rapid long-lasting symptom relief
• Dramatic urine flow improvement
• Safe and effective for use in men in urinary retention, with large
prostates or on anticoagulant therapy
• Alternative to the cost, side effects and
inconvenience of other therapies
Per the American Urological Association guidelines,
laser therapy provides equivalent symptom relief compared to TURP
How GreenLight Laser Therapy Works:
• Uses laser energy to remove
excess prostate tissue by vaporization
• Laser energy is delivered
through a small, flexible fiber
inserted in the urethra
• The procedure can be performed in a hospital
outpatient center or surgical center
Clinical Comparison
GreenLight
Length of
TURP
1.1 days
3.4 days
12.2 hours
44.5 hours
Hospital Stay
Length of
Catheterization
GreenLight Treatment Shots
Pre-op
Immediate post-op
3 months post-op
TURP like results with
fewer side effects
Photos courtesy of Mahmood A. Hai, M.D.
Side Effects
•
Hematuria – Blood in the urine
•
Bladder spasm or urgency
•
Irritation of urinary tract –
frequent urination, burning sensation
•
Retrograde ejaculation
- 36% for GreenLight Procedure
- 53 - 75% for TURP Procedure
Affect on Erectile Function
•
Does NOT affect Erectile function
- There is no difference between
pre-operative and post-operative
function after treatment for
men with either mild or no erectile
dysfunction preoperatively.
•
Does NOT affect your ability to take erectile
dysfunction medications
Insurance Coverage
•
Covered by Medicare and most
private insurance companies
•
Can be an economic alternative to
the ongoing cost of medications
What to Expect During Treatment
•
May be given medication to help you relax
•
IV sedation or anesthesia that will allow you to sleep
through the procedure
•
Minimal to no discomfort
Post-Treatment Expectations
• Dramatic symptom improvement
immediately
• Typically able to leave outpatient
facility within hours after treatment
• Many patients leave without a catheter; however, if
one is required it is typically removed in less than 24
hours
• Can resume normal activities within a few days and
strenuous activities within two weeks
Am I Eligible For This Treatment?
Of the BPH treatments available, GreenLight has the
widest patient selection
•
Potential candidates may include men who are:
–- Not satisfied with medication therapy
• Loss of effectiveness, costs, side effects
• Don’t want to take medications
• Want better symptom relief than with medications
-On anti-coagulation therapy
-Mildly to severely symptomatic
Consultation with your Urologist is required to determine if
GreenLight is the best treatment option for you.
Questions?
Thank You
Men’s Health Talk
Contact Info
• 302 Hospital Road, Starkville MS 39759
• 662-615-3756