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The Journal Gazette

  • Thomas

Thursday, June 22, 2017 1:00 am

Enlarged-prostate procedure expanding

Vivian Sade | For The Journal Gazette

At a glance

UroLift implants

•A new, minimally invasive procedure that effectively treats prostatic hyperplasia, or BPH, a condition in which the prostate enlarges as a man ages, creating lower urinary tract symptoms.

•Placing the UroLift system takes minutes and can be done in a doctor's office. Patients see immediate results and incur minimal downtime. The system resolves most urinary tract problems without compromising sexual function.

•For most patients, the cost of the UroLift implant system is about the same or less than two years of pharmaceutical treatment for BPH.

•Learn more at UroLift.com.

A new medical procedure is changing the lives of older men affected by benign prostatic hyperplasia, or BPH, a condition in which the prostate enlarges as a man ages.

More than 70 percent of men in their 60s – nearly 12 million in the U.S. alone – experience BPH. When the enlarged prostate presses on the urethra it causes a frequent need to urinate, weak or slow urinary stream or other urinary tract problems.

Treatment options include medication, laser treatment, thermotherapies and traditional surgery. Medication can be costly or intolerable because side effects while surgery and laser treatment are more invasive with more potential for hospitalization.

But a fairly new, minimally invasive procedure called the UroLift system by NeoTract Inc. can be implanted in minutes in a doctor's office using local anesthesia. The UroLift system consists of a delivery device, tiny implants and four sutures that lift or hold the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue and results are immediate.

Dr. Adam Craig Thomas of Northeast Indiana Urology on Dupont Road has implanted UroLift systems in 75 men since July. He recently began seeing patients every Tuesday and some Mondays in Angola – where he grew up – at Cameron Memorial Community Hospital.

“It's life-changing,” Thomas said of the UroLift procedure. “Men come into my office and a few minutes later they can walk out of here and urinate with no problem.”

Although the procedure is simple and can be done in a doctor's office, Thomas prefers an operating room.

“I prefer the operating room with anesthesia support,” Thomas said. “I use a light anesthesia because the patient is more comfortable, and compassionate care is important.”

Margaret “Peggy” Schrei­ber, Cameron's director of surgery, agrees. She works with Thomas to schedule the procedures at the hospital.

“There are risks with anesthesia but having someone under anesthesia for five minutes to implant a UroLift system versus two to three hours for traditional surgery certainly reduces the risks,” Schreiber said. “And burning away prostate tissue has more of a potential for a longer hospital stay.

Home same day

Benefits of the UroLift system include the preservation of sexual function, minimal downtime post-treatment, and most patients go home the same day without a catheter, Thomas said.

“No, it won't work for all, but a significant number of men can be treated” with UroLift, he said.

UroLift is reversible and has durable results, Thomas said. It can even offer a cost-savings for some patients. Many patients who are prescribed pharmaceuticals to treat BPH are on those medications for years – sometimes for life – and often end up having laser treatments or surgery anyway, Thomas said.

“The UroLift system is less expensive or the same cost as two years (of pharmaceutical treatment) for many patients, without the side effects of some of the medications,” Thomas said.

Side effects can include feeling run down, congestion, retrograde (reverse) ejaculation, dizziness and floppy eye syndrome.

The FDA cleared UroLift in 2013 and it was launched in select markets in the U.S. in 2014, but Thomas did not do his first implant until last summer.

“I passed on it a few years ago because I wanted to see some data,” Thomas said.

After a patient asked about the procedure, Thomas continued to research the UroLift system and later attended a medical conference where the results of a three-year clinical study were released. The results were promising.

“I said to the patient, 'Let's do this,' ” Thomas said.

On May 8, Thomas attended the 112th American Urological Association meeting in Boston, where urologists received five-year follow-up data on UroLift. The study evaluated the safety and effectiveness in patients with BPH who had been treated with UroLift systems.

The study reported a 50 percent improvement with only a 2 percent to 3 percent re-treatment rate per year.

“In other words, about 90 percent of patients are a lot better (50 percent better) at five years without any other help,” Thomas said.

Quality of life

“I've had patients with catheters who were told to just go on with life, but living with a catheter is awful,” Thomas said.

“Getting up at night four or five times to urinate is awful. This is a great option for them,” he said.

Like Thomas, Schreiber has seen the effects of BPH and sleep deprivation on older men.

“Before they have this done they might have been getting up multiple times during the night, can't sleep and consequently, are tired all day. Sleep deprivation can be awful for them,” Schreiber said. “This procedure can be done as an outpatient and there is no removal, burning or cutting of prostate tissue,” she said.

The director of surgery isn't the only who is thrilled that Thomas will be seeing and scheduling patients at Cameron.

“We are thrilled to have Dr. Thomas in Angola to help patients with urology needs,” Cameron's spokes­woman Laura Lutterbeck said.

“It is always very positive when we can offer services to our patients such as the UroLift that can change the quality of life for our patients without having to leave the county.”

Thomas enthusiastically supports the procedure.

“This is a special interest of mine,” Thomas said. “I love it because I can take a guy and change his life,” he said. “These are happy, happy patients.”

UroLift is available in the United States, Europe, Australia and Mexico.

A colleague of Thomas who lives in Israel, where the UroLift is not available, is planning a trip to northeast Indiana to have the procedure done by Thomas.

“Our results are very good,” Thomas said.