A new minimally invasive procedure to treat men with an enlarged prostate has been implemented at an El Paso hospital. Scott Brocato recently spoke with Dr. Jesus Herrera-Murillo, a urologist and physician with Rio Grande Urology and the Hospitals of Providence Transmountain Campus, about the new procedure.
SCOTT BROCATO:
The Hospitals of Providence Transmountain Campus is the first hospital in El Paso to introduce the HoLEP procedure. You performed the first successful procedure in El Paso. Tell us about the HoLEP procedure. First of all, what does HoLEP stand for?
DR. JESUS HERRERA-MURILLO:
HoLEP stands for Holmium Laser, which is the laser technology that we use to help us make incisions and cauterize what we’re working; and then Enucleation of the Prostate, which is the rest of the sentence. And that just means it's the technique that you use to essentially enucleate the prostate that is causing obstruction for most of these men. The procedure is a minimal-invasive procedure. It's meant for men with enlarged prostates, but basically it could be used for any size of prostate.
And some of the symptoms that guys will have would be, you know, increased in nighttime urination; weak stream; urgency; frequency; sometimes post-void dribbling; sometimes some incontinence; or chronic catheter patients or patients who ended up with a catheter because they're not able to pee. This procedure helps not just men who have these problems, but even the complex patients who maybe are on blood thinners and who have very, very, very large prostates. This will give them a solution to have a procedure that is essentially outpatient, that the risks of bleeding are very low, and pain-wise is very tolerable. And so it really exemplifies what minimal invasive is for this era.
SCOTT BROCATO:
Let's talk a little bit about BPH, Benign Prostatic Hyperplasia. It affects an estimated 70% of men aged 60 to 69 and 80% of men over 70. What are some health issues that can occur if BPH is left untreated?
DR. JESUS HERRERA-MURILLO:
My biggest concern with untreated BPH, especially for, you know, the guys that are having starting to have symptoms in their 50s, is by the time they show up in their 60s, 70’s, even 80s, they've already had many years with high pressure voiding. Your bladder is a very smart organ. It will overcompensate an outlet obstruction, or what BPH will essentially block. And however long-term, the bladder tends to get tired, and you run the risk of ending up with a catheter or chronically damaging the bladder to the point where it may not function. And unfortunately it's a very preventative disease, but long-term obstruction can lead to renal failure from upper tract disease that happens from the blockage. It can lead to neurogenic bladders, and it can lead to chronic catheterizations and urinary tract infections. And so if treated early or if, you know, at least being evaluated early on, the goal will be to prevent these things to happen once you start getting up there in age.
SCOTT BROCATO:
And what age should men start getting their prostates checked and how often? I've heard many different answers. Every five years? Every 10 years?
DR. JESUS HERRERA-MURILLO:
In general, most men will start seeing a urologist around their 50s. You know, PSA prostate cancer starts to be screened around 50, 55. And so most men will end up seeing a urologist by then. I have a couple patients who start seeing me in their 40s, especially if they've had family history of enlarged prostates, but most men will start coming in in their 50s. If you've never seen a urologist and you're getting up there (in your) 60s, you know, 70s with symptoms, then you should definitely at least have a conversation about overall prostate health. I think in general, a general practitioner can check it; but if you're having symptoms, once a year, check up with a urologist. Some guys, I see them every year; some guys I see them every one to two years, depending on how severe their symptoms are. But the goal is to get it early and to treat it early.
SCOTT BROCATO:
And where can people find out more about the HoLEP procedure?
DR. JESUS HERRERA-MURILLO:
So Boston Scientific, their website has some information about Holmium Laser Nucleation of the prostate. You know, if you call Rio Grande Urology and you want to get an appointment with me, I'm happy to talk to you about the procedure. You know, there are other procedures that we can do as well. But if you're interested in the HoLEP, that would be one. I'm still in the process of working to get more information out there with videos and stuff like that to kind of explain it. Right now, if you just call Rio Grande Urology, you can make an appointment with me and we'll get you seen.
