From laparoscopic surgery for female incontinence to robotic prostatectomies to GreenLightTM Laser treatment for an enlarged prostate, physicians on the medical staff at Texas Health Harris Methodist Hosptial Southwest Fort Worth perform a broad range of advanced procedures for urological conditions.
Benign Prostatic Hyperplasia (BPH)
BPH is a non-cancerous enlargement of the prostate that restricts urine flow, causing frequent urination, the sudden need to urinate and dribbling or leaking. BPH affects approximately 50 percent of men between the ages of 51 and 60, and up to 90 percent of men over the age of 80, according to the American Urological Association.
Photoselective vaporization of the prostate (PVP) using the GreenLightTM Laser system is a simple and effective solution for men with BPH. A breakthrough in the surgical treatment of BPH, PVP is a minimally invasive procedure which uses a high-powered GreenLight laser to vaporize and precisely remove enlarged prostate tissue. Most PVP patients return home the same day as surgery. Prior to the availability of the PVP procedure, patients had to choose between an effective, but invasive, surgery requiring a hospital stay and longer recovery period or other safe, but less effective, therapies.
More than 15 million Americans, mostly women, have urinary incontinence (the inability to control urination), according to the American Urological Association. Physicians on the medical staff provide behavior modification techniques, advanced surgical procedures and other techniques for curing incontinence.
Female Urinary Incontinence
Women experience incontinence almost twice as often as men. Some are embarrassed by leaking urine when they cough, sneeze or exercise; others experience such a strong urge to urinate and are unable to control it.
There are several types of incontinence:
- Stress - leakage of small amounts of urine during physical movement (coughing, sneezing, exercising)
- Urge - leakage of large amounts of urine at unexpected times, including during sleep
- Functional - untimely urination because of physical disability, external obstacles or problems in thinking or communicating the prevent a person from reaching a toilet
- Overflow - unexpected leakage of small amounts of urine because of a full bladder
- Mixed - usually the occurrence of stress and urge incontinence together
- Transient - leakage that occurs temporarily because of a condition that will pass (infection, medication)
Incontinence has many treatments, ranging from Kegel exercises to electrical stimulation to bladder training to medications. In some cases, implants (which reduce stress incontinence by adding bulk to help close the urethra) and surgery may also be necessary.
One goal of surgery is to return the bladder and urethra to its normal position. Severe cases of stress incontinence may be treated with a sling procedure which secures the bladder. The wide sling holds up the bladder and compresses the bottom of the bladder and the top of the urethra, preventing leakage.
In rare cases, a surgeon implants an artificial sphincter, a donut-like cuff placed around the urethra. A reservoir pushes fluid to expands the sac, which squeezes the urethra closed. By pressing a valve implanted under the skin, the artificial sphincter deflates. This removes pressure from the urethra, allowing urine from the bladder to pass.
Physicians on the medical staff provide surgical and non-surgical treatments for erectile dysfunction, the inability to get or keep an erection firm enough for sexual intercourse.
In older men, erectile dysfunction usually has a physical cause, such as disease, injury or side effects of drugs, according to the National Institutes of Health. Incidence of erectile dysfunction increases with age: about five percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience erectile dysfunction. However, erectile dysfunction is not an inevitable part of aging; a number of advanced treatments are available.
Physicians on the medical staff offer a new advanced, less invasive alternative to traditional prostatectomy (removal of the prostate, usually due to prostate cancer).
The da Vinci® system is a surgical robot that is controlled by surgeons seated at a console next to the patient's bedside. This new technology allows surgeons to treat complex surgical cases with controlled precision and accuracy. Tremor is eliminated; the right and left hand are ambidextrious; and the "hand" movements are extremely delicate.
For many patients, surgery performed using the da Vinci system has a number of benefits, including:
- Smaller incisions
- Less pain
- A shorter hospital stay
- Quicker recovery
- Faster return to normal activities
Follow this link to learn more about da Vinci minimally invasive surgery.
Pelvic Floor Repair
The pelvic floor is composed of muscle fibers that form a "hammock" from the front of the pelvis to the back. This sling of muscles supports the pelvic organs (bladder, uterus and rectum). If the pelvic floor is weak, the pelvic organs may protrude out of the vagina. This is referred to as pelvic organ prolapse.
Pelvic floor weakness is often due to pregnancy, childbirth, obesity, menopause or excessive straining such as with a chronic cough, constipation or the presence of a pelvic mass. Symptoms of a weak pelvic floor include:
- Uncomfortable lump
- Urinary or bowel difficulties
- Painful sexual intercourse
Pelvic floor repair is an operation that restores the support of the pelvic organ.