STEVE INSKEEP, host:
It's MORNING EDITION from NPR News. I'm Steve Inskeep.
RENEE MONTAGNE, host:
And I'm Renee Montagne.
Today in Your Health, the benefits of ballroom dancing and the newest laser technology to treat a problem that can be a burden for aging men - benign prostate hyperplasia, or BPH.
NPR's Patty Neighmond reports on the newest technique for treating the disorder.
PATTY NEIGHMOND: If you're over 50 and male, chances are your prostate, which is a small walnut-shaped gland that surrounds the urethra, is larger than it was when you were 30, and as it gets bigger, so do symptoms that can disrupt your life.
Mr. BUD GRUBER (Retired Clothier): My name is Bud Gruber. I'm retired. I had been in the men's and ladies' clothing business in suburban Philadelphia.
NEIGHMOND: When he was about 62, Gruber noticed, he had to go to the bathroom more often and with greater urgency.
Mr. GRUBER: I knew where every restroom was in every gas station, every church, every department store. I knew where every secluded tree was when I used to walk in the mornings.
NEIGHMOND: The diagnosis: BPH, benign prostate hyperplasia, or an enlarged prostate.
Mr. GRUBER: I could be driving and all of a sudden an urge would come on; I'd have to stop the car and jump out. It got to a point where sometimes I even carried a urinal in the car. I just didn't have control of my functions.
Dr. DAVID CHAN (Johns Hopkins University): Mr. Gruber, thanks for coming in. How have you been?
Mr. GRUBER: I've been great, thanks, Dr. Chan.
Dr. CHAN: Wonderful.
MONTAGNE: Gruber eventually came to Johns Hopkins University to see Dr. David Chan. Chan says a blocked urethra is common among patients with enlarged prostates.
Dr. CHAN: Think of it as like a donut with a donut hole. As the prostate enlarged, that donut hole gets smaller and smaller. And so we have increased resistance, increased difficulty of passing, passage of urine flow. And so the bladder has to work harder to squeeze out the urine.
So when you have high pressure, you have discomfort in the pelvic area; your flow will be diminished and you may finally don't empty your bladder completely because your bladder simply can't force out enough urine to empty the bladder.
MONTAGNE: In the short term, medication can help. But as the prostate grows, Chan says, a more invasive procedure is needed in order to solve the problem.
Dr. CHAN: Historically, before the 1980s, the TURP, or trans-urethral recession of prostate - the Roto-Rooter - was really the gold standard, because there was really nothing else to offer patients. In fact, the TURP was really the number one procedure that was performed, second only to probably cataract surgery.
MONTAGNE: TURP is still used in about half of all enlarged prostate surgeries, but there can be complications like excessive bleeding. So when Bud Gruber came to see Dr. Chan, there were less invasive alternatives to discuss: several procedures that heat up prostate tissue and cause it to die off; and there's more, including one that evaporates tissue with an electrical current. But for Gruber, Chan suggested a procedure that uses a laser developed three years ago. The laser probe vaporizes tissue and seals off blood vessels as it travels through the urethra to the bladder.
Dr. CHAN: Essentially, there is a fiber that is about, you know, one and a half millimeters in diameter that is inserted through the telescope. It's a side-firing laser fiber, meaning that it doesn't fire straight ahead; it fires about 70 degrees to the side. And then you circumferentially vaporize that tissue. And once you are able to create a channel that's complete, then the procedure is completed.
MONTAGNE: Because there's less bleeding, patients don't have to spend the night in a hospital like they do with TURP. And recovery is quicker than with TURP. In both procedures, however, Chan says there are very rare side effects. About one percent of patient's may suffer incontinence or impotence.
Laser technology hasn't been studied over the long term. It would be useful to know how long laser works to keep the urethra open, compared to traditional TURP. TURP lasts about 8-10 years. Budd Gruber picked the laser surgery and it made a big difference for him.
Mr. GRUBER: It was like alpha to omega, and I just couldn't believe the difference in my lifestyle. I was able to go out and not have to worry where every men's room in every gas station, every store was. I was a new man.
MONTAGNE: The new laser of procedure isn't available everywhere in the country. The laser is expensive, and many smaller hospitals and doctor groups just can't afford it. Both Medicare and private insurance cover the cost of most of the procedures.
Patty Neighmond, NPR News.
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