Louisville Medicine Volume 70, Issue 12 | Page 26

New Trends in the Treatment of Prostate Surgery

On Tues ., March 7 , the GLMS Foundation Senior Physicians Speaker Series welcomed Dr . W . Cooper Buschemeyer III to speak on new trends of treatment in prostate surgery . Interim Chair , Dr . Sam Yared , shared that he got his undergraduate degree from the University of Louisville and his medical degree at the Royal College of Surgeons in Ireland . He then went on to complete his residency and fellowship in urological surgery at Duke University and studied cancer biology at MD Anderson Cancer Center in Houston , Texas . He specializes in robotic surgery procedures such as prostatectomy , cystectomy , reconstructive bladder surgery and nephrectomy . He is also the son of Dr . W . Cooper Buschemeyer Jr ., a urologist here in Louisville .

The overwhelming majority of symptoms of enlarged prostate onset at ages 70-79 , but Dr . Buschemeyer said he has seen patients as young as 30 with these symptoms . There are many complications that occur with untreated benign prostatic hyperplasia ( BPH ) with bladder outlet obstruction ( BOO ). While many people may think of acute urinary retention , this symptom comes on later and many patients have had symptoms for many years before this happens . Urinary tract infections are the most common ; in men , this often indicates some kind of BOO . Other complications can include bladder calculi , bladder damage , renal impairment and hematuria . Hematuria is the most common presentation for BPH .
Fortunately , there are many surgical procedure options for enlarged prostate that are less invasive than open surgery . A transurethral resection of the prostate ( TURP ) was once considered the gold
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standard but many urologists , including Dr . Buschemeyer , haven ’ t done this procedure in over a decade because there are newer , better options . For younger patients , one can do a transurethral incision of the prostate ( TUIP ) to preserve sexual function . Dr . Buschemeyer has transitioned from the TURP to laser ablation of the prostate , where he can do everything he could with a TURP , removing obstructing tissue , but vaporizing it with a laser . There is less bleeding , it can be done in the outpatient surgery center , and the patient can go home 30 minutes after the procedure , as opposed to days in the hospital .
However , with about 98 % of the patients that Dr . Buschemeyer treats for enlarged prostate , he uses the Rezum procedure . Unlike some other thermal therapies , Rezum uses water vapor therapy that allows for a uniform delivery of heat with convection from steam . In most cases , it does not cause necrosis of the tissue , but instead induces apoptosis in the cells . It is done in the office and takes just a few minutes - less than two minutes of actual treatment time - consisting of three to 12 injections , each one eight seconds long . In a five-year study , it was found that only 4.4 % of patients went on to have another type of procedure ( or another Rezum procedure ), and 11.1 % of patients went back on medical therapy for their outlook symptoms .
There will not be a Senior Physicians Speaker Series presentation in May . We will resume Tues ., June 6 . To view Dr . Buschemeyer ’ s full presentation or to catch up on one you may have missed , email foundation @ glms . org .
Kathryn Vance is the Communication Specialist at the Greater Louisville Medical Society .