Eine vergrößerte Prostata, auch benigne Prostatahypertrophie (BPH) genannt, betrifft fast alle Männer ab 50 Jahren. Bei der BPH kommt es zu einem übermäßigen Wachstum von Prostatagewebe, das gegen die Harnröhre und die Blase drückt und den Urinfluss einschränkt. Es ist wichtig, im Hinterkopf zu behalten, dass das „B“ in BPH für gutartig steht, BPH ist also keine Krebserkrankung2.
Eine vergrößerte Prostata allein kann Symptome verursachen oder auch nicht (die Größe der Prostata ist kein Hinweis auf den Grad der Harnwegssymptome). Der Grad der lästigen Symptome ist jedoch der häufigste Grund, warum Männer zum Arzt gehen.
Das häufigste Symptom sind Schwierigkeiten beim Wasserlassen:
Die Art und Schwere der Symptome und der Grad der Lästigkeit oder Beeinträchtigung des Lebens des Patienten, sind wertvolle Fakten, die dem Arzt bei der Diagnose helfen. A simple questionnaire called the International Prostate Symptom Score (IPSS) is a common starting point2.
A patient voluntarily empties his baldder, and the amount and speed of urine flow are measured. A special device can help physicinas detect reduced uring flow associated with BPH2.
The Digital Rectum Exam (DRE) test is performed by the Urologist who will use their gloved index finger to feel your prostate through the rectal wall to assess the size, shape and stiffness of your prostate1.
Prostate Specific Antigen Test (PSA) is a protein made b prostate tissue. The amount of PSA measured in your blood normally increases with age and prostate size, but abnormally high levels may indicate the need for additional testing1.
1. National Cancer Institute. (2011, August). Understanding Prostate Changes. Aufgerufen: http://www.cancer.gov/types/prostate/understanding-prostate-changes/prostate-booklet.pdf .
2.American Cancer Society. (2015, March 12). Prostate Cancer. Atlanta, GA: American Cancer Society. Aufgerufen: http://www.cancer.org/acs/groups/cid/documents/webcontent/003134-pdf.pdf
3.Rukstalis, D. B. (2002). reatment options after failure of radiation therapy—a review. Reviews in urology, 4(Suppl 2), S12. Aufgerufen https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477547/
4.National Cancer Institute. (2019, June 12). Prostate Cancer. National Cancer Institute. Aufgerufen: https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq
5.Radiologyinfo.org (2019, May 01). Brachytherapy RadiologyInfo.org for Patients. Aufgerufen: https://www.radiologyinfo.org/en/info.cfm?pg=brachy
64 years old
“By far, the TULSA Procedure had the lowest risk of any treatment out there. To me, there was no question. If you are a candidate for the TULSA Procedure, please consider it.”
My wife and I hadn’t seen a doctor in many years, so in 2019, we decided to get physicals. I found out that my PSA was elevated. After another PSA test with elevated results, I was referred to a urologist.
In between that time, I came across an article on-line about a new procedure for prostate cancer called the TULSA Procedure. When I read the article, I didn’t know that I definitely had prostate issues. I always knew it was a possibility, but for some reason, that article stuck with me.
After another PSA test with elevated results, a positive prostate biopsy, and genetic testing confirming a more aggressive type of cancer, my physician recommended treatment and referred me to a surgeon. I started researching what my options were knowing I had to do something.
I decided I had to get more information to determine if the TULSA Procedure was a viable option. I started researching and looked at some of the TULSA Procedure studies. What I was able to determine was that for short term side effects, there really is no comparison between the TULSA Procedure and other treatment options.
I was hesitant about having surgery because anything can happen when you start cutting into the body. My brother also had prostate cancer and ended up getting surgery (twice) and radiation. He experienced issues afterwards and said to avoid surgery if at all possible. I also talked to a few other people I knew that had had prostate cancer, and all of them said to avoid surgery. From a relationship standpoint, my wife just said that she didn’t care what I did, she just wanted me to be around.
After meeting with a surgeon, my wife and I decided that was not the way I wanted to go. For me, surgery was going to be more expensive than other options, and I would have probably needed radiation on top of that. I’m looking at quality of life and surgery is risking your quality of life. I’m only 63. I don’t want to have a bag for the rest of my life. With the TULSA Procedure, it was likely that I would not need radiation, there was less risk of side effects which meant a better quality of life afterwards.
I had to get a new Urologist to proceed in the direction that I wanted. You have to make your own decisions about what you want to do to yourself, and you cannot be afraid to make difficult decisions. After conversations with my Urologist and their surgeon and their lack of knowledge or interest about new developments for the treatment of prostate cancer, my wife and I knew we had to make a change.
It is important to remember that Doctors are not God and they only know what they have learned or been exposed to. If they are not listening to you or you don’t think they are giving you the best advice for your condition, you have to have the courage to make the best decision for yourself.“
I also looked at HIFU, and from my understanding, it works like a pencil eraser, delivering treatment line-by-line so one of the problems is that it could miss some cancerous tissue. I was concerned about getting rectal or bladder damage from the heat. With the TULSA Procedure, the device rotates in a cooling tube and has 10 rotating transducer elements delivering the treatment with direct MRI feedback to ensure the tissue is heated to the proper temperature to kill the cancerous tissue but not too high to damage any non-cancerous tissue. So, to me, there’s no comparison between these two treatments either.
I can’t say enough about Dr. Dora’s team at the Mayo Clinic in Jacksonville. He, his nurses, the technicians, and the other staff were amazing. Because there are three different doctors in the room – the urologist, radiologist, and anesthesiologist, you’re getting three different perspectives on what the treatment should be.
As far as the actual procedure versus an operation, there is no comparison. In general, there is no recovery. I didn’t have any pain. If it wasn’t for the catheter, I would not have known anything was done. If I had had surgery, it would have taken a lot longer to recover with more pain.
You have to make your own decision and be informed. Being informed means that you know the possible treatment options available and you understand their benefits and risks. As a patient going through this procedure, I can say that this was the best decision I could have made to treat this problem. And I did not go into it blindly. I knew there were risks, but I looked at the risks of all potential treatments. By far, the TULSA Procedure had the lowest risk of any treatment out there. To me, there was no question. If you are a candidate for the TULSA Procedure, please consider it.
There are things I talk about now that I never thought I’d be talking about – like urinary issues and ED issues. I know that a lot of men don’t want to talk about prostate issues or the possible side effects of prostate treatment, but it’s important. If you were to ask me two years ago, if I would be talking openly about my prostate issues and experience, I would say no. Now, I won’t stop talking about it.
I hope information about this procedure gets out to Urologists and to their patients. I am glad I had the choice.
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