Going with the flow

Prostate vaporization is:

A. the subject of a lost "Star Trek" episode featuring an ill-fated Scotty

B. in some countries, the punishment for leaving the toilet seat up

C. a legitimate medical procedure - you hope

Yes, despite the sinister-sounding name, prostate vaporization is an actual procedure. In fact, if you're a man who's having a little trouble "going with the flow," it might be right up your alley.

Used by urologists to treat enlarged prostates, the vaporization technique is accomplished with a system known as GreenLight PVP, which uses a laser to zap prostate tissue that is blocking urine flow. This clears a path for a normal stream and provides fast relief of symptoms and little postoperative bleeding.

Enlargement of the prostate - a condition known in the medical community as benign prostatic hyperplasia, or BPH - is pretty common and occurs naturally with the aging process. The result of all this growth in some men is a constriction of the urethra - a tube that transports urine out of the body and passes through the prostate and into the bladder.

According to the Mayo Clinic, half of men in their 60s have BPH symptoms; in those over the age of 80, it's about 90 percent. Symptoms of the condition include dribbling after urination, frequent urination (especially at night), a hesitant or weak urine stream, a sudden or urgent need to urinate and the feeling of having a not-quite-empty bladder.

If BPH is left untreated, it could lead to frequent urinary tract infections, a weakened bladder or chronic kidney infections.

Not exactly a pleasant list.

So it's no surprise that Mid-Hudson Urological Associates in Newburgh sees a fair share of enlarged prostates come through the door.

Out of the multitude of surgical treatment options out there for BPH, the minimally invasive GreenLight has become one of the favorites, says Dr. Conrado Tojino Jr. of Mid-Hudson Urological. He's been using the device since last year, and so far, patients have been very pleased with the results. "They have a strong stream, and it's like they're 20-year-olds again," he says.

The gold standard for treating enlarged prostates has been to carve out meddlesome enlarged prostate tissue with a special cutting instrument (during a procedure known as TURP, or transurethral resection of the prostate). Patients can expect to spend a few recovery days in the hospital with a catheter. Despite the improved urine flow and long-lasting results, the invasive surgery can be bloody and involve a six- to eight-week healing period, Tojino says. There is also the risk of side effects such as impotence and incontinence.

The GreenLight, which has been on the market for five years, has proven to be just as effective, delivering high-powered green laser light to literally vaporize prostate tissue. Depending on the size of the prostate - normally the size of a walnut but in many cases enlarged to the size of a plum - the procedure can take from as little as 30 minutes to an hour and a half. The device also cauterizes as it goes along, so there is little to no blood loss during surgery.

The patient has an overnight hospital stay with a catheter and then is on his way, "peeing up a storm," Tojino says.

Besides the benefit of a shorter hospital stay, the procedure doesn't carry the same risk for impotence or incontinence because the laser's energy is more targeted - meaning no risk of injuring the nearby nerve that aids erections or the muscle that helps prevent urine leakage.

Possible side effects following the procedure include burning urination for a couple of weeks and a condition known as retrograde ejaculation - when semen pushes back into the bladder instead of going out through the urethra.

There is also the possibility that in 10-15 years the prostate tissue may grow back. The area can always be retreated, Tojino says.

Unlike the hush-hush world of women's urinary problems, Tojino says most of his patients are pretty open with their issues. "Men at this age are OK with saying, 'Doc, I can't pee. I need some help,'" he says.