Laser techniques have made many medical treatments more effective. Now, the technology shows promise in treating men with enlarged prostates.
The prostate, a walnut-shaped gland that sits behind the pelvic bone, aids male sexual function. Most men older than 60 have enlarged prostate tissue, which can grow to obstruct the urethra, making it more difficult to control bladder function.
Bud Gruber, a retired clothing manufacturer from Philadelphia, was diagnosed with an enlarged prostate when he turned 62, after he noticed that he had to go to the bathroom more frequently and with greater urgency.
"I knew where every restroom was and [where] every gas station, every church and department store was -- where every secluded tree was -- when I used to walk in the mornings," he says. "I could be driving and all of a sudden, I had to jump out of the car. Sometimes, I'd keep a urinal in the car. I just didn't have control of my functions."
His doctor, David Chan, a urologist at Johns Hopkins, says a blocked urethra is common among patients with enlarged prostates.
"Think of [the urethra] as a doughnut with a doughnut hole," he says. "As men age and prostate enlarges, that hole gets smaller. And you have to work harder to squeeze out the urine. With more pressure, there's more discomfort, [your] flow is diminished and the bladder simply can't force out the urine."
Medication can help in the short term, but as the prostate grows, Chan says invasive procedures may be needed to stop blockage.
"Historically, the transurethral resection of the prostate (TURP) -- the [so-called] roto rooter -- was the gold standard because we had nothing else to offer patients," Chan says. "In fact, the TURP was the No. 1 procedure performed next to cataract surgery."
But invasive surgery can have complications, like excessive bleeding. Most patients now opt for an alternate laser procedure which doctors use to minimize risks.
In the new procedure, a laser probe is used to melt away excess tissue. As it goes through the urethra, the probe coagulates blood vessels and seals them off, which prevents hemorrhaging.
Laser patients don't have to spend the night in the hospital, and they have a faster recovery period than patients who opt for the TURP procedure. In both, Chan says, there is about a 1 percent risk of incontinence or impotence.
Bud Grober, like most of Dr. Chan's patients, opted for the laser procedure and says the surgery changed his life.
"It was like alpha to omega," Grober says. "And I just couldn't believe the difference in my lifestyle. I could go out and not have to worry where every men's room and gas station and store was. I was a new man."
There are some caveats to the laser procedure, namely that it hasn’t been studied over the long term. The benefits of the traditional TURP procedure lasts 8 to 10 years; it's not yet known how long the benefits of the laser procedure last. The laser procedure is also more expensive, but Medicare and private insurance generally cover both procedures.
Researchers say the laser procedure may eventually save money because patients spend less time in the hospital and suffer fewer complications.