MEDICAL

COLIN TEO UROLOGY

Recent years have seen the introduction of a wide spectrum of exciting new medical technologies in Prostate treatments . These innovations are witnessing a rising trend of acceptance and preference among men ( both young and old ) as they are minimally invasive and safe whilst providing personalised alternative options catering to the different needs of each individual patient . Many of these can be performed under outpatient or day surgery with or without sedation avoiding general anesthesia . This is in contrast to traditional options where one had to choose between either taking multiple medications that could lose their effectiveness as the disease progressed , including having compliance issues and side effects , or the alternative of more invasive or radical surgeries .

In the field of Benign Prostatic Hyperplasia ( BPH ), which is a highly prevalent and bothersome benign condition in men , the exciting new innovations bring advantages of lower risk of complications with good preservation of sexual function important to many men . These innovations include :

• Prolieve Thermodilatation , a truly outpatient procedure that can be done under local anesthesia , that shrinks the prostate using a microwave chip catheter with balloon dilatation creating a ‘ Biological Stent ’.

• REZUM water vapor therapy procedure that shrinks the prostate with a simple 10-minute endoscopic day surgery procedure .

• Urolift system that cleverly inserts clip implants that spread open the

Dr Colin Teo

obstructing prostate from blocking the urethra , thereby improving flow without shrinking the prostate .

• iTind ( Temporary implantable Nitinol Device ) An alternative implant device that only requires temporary placement which remodels the prostate over one week , after which it is removed .

• Laser Ablation An endoscopic vaporisation of large prostates that minimises bleeding , yet ensures a wide-open channel of unobstructed flow .

• EXMINE Stent a creative device that gives patients the option of avoiding a urinary catheter . When inserted , it is unseen and hidden in the body without the need for handling an external urine bag that can be bothersome and socially awkward . The stent can be changed or removed outpatient when due . Prostate Cancer has largely been treated by the minimally invasive and safe keyhole DaVinci Robotic Surgery which brought operative technology to a new level of precision and dexterity with faster recovery times and functional outcomes . For selected suitable patients , the latest developments are providing personalised options for targeted therapy either through High Intensity Focused Ultrasound ( HIFU ) or Cryotherapy targeted therapy where cancer treatment may be designed to ablate half or a part of the prostate where a visible tumour can be localised and thus avoid the comorbidities of cancer surgery .

In younger patients where BPH and Prostate Cancers are not prevalent , many do suffer from Chronic Prostatitis , Erectile Dysfunction , and Peyronie ’ s disease . While medications do bring relief , many patients find persistent or worsening disease progression despite taking them . Low intensity Shockwave Therapy which is performed painlessly in an outpatient clinic setting has been shown to be effective . It has been used for many years in sports medicine where it has a good track record with no significant known side effects . Research and clinical studies have shown that shockwave therapy promotes prostate and penile tissue healing through release of beneficial growth factors that promote better vascular flow , decreased proinflammatory activities , endogenous stem-cell recruitment , and nerve repair .

We are indeed enjoying this era of translational innovations that have delivered a wide armamentarium of minimally invasive and effective therapy options for patients , and there is no doubt newer technologies will continue to make their way into minimally invasive prostate therapy .

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