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Urologists located in Mesa, AZ

Male Sexual Health in Arizona: An Essential Guide

Male sexual health is a vital aspect of overall well-being, often overlooked in discussions surrounding health and wellness. Understanding the nuances of male sexual health can lead to improved quality of life, better relationships, and enhanced self-esteem. Here’s a comprehensive guide to the key factors influencing male sexual health, common issues, and strategies for maintaining sexual wellness.

Understanding Male Sexual Health

Male sexual health encompasses various physical, psychological, and emotional aspects of sexual function. It includes everything from libido and erectile function to sexual behavior and reproductive health. Recognizing the importance of sexual health can empower men to seek help and maintain a fulfilling sexual life.

Common Issues Affecting Male Sexual Health

1. Erectile Dysfunction (ED): A prevalent condition affecting men of all ages, ED can result from psychological factors (like stress or anxiety) or physical conditions (like diabetes or cardiovascular disease). Addressing underlying health issues and seeking professional advice can help manage this condition.

2. Low Testosterone Levels: Testosterone plays a crucial role in male sexual health, influencing libido, energy levels, and mood. Low testosterone can lead to reduced sexual desire and other health issues. Regular check-ups and lifestyle adjustments can mitigate these effects.

3. Premature Ejaculation: This common concern can cause anxiety and relationship issues. Various techniques, including behavioral therapy and medications, can help men gain better control.

4. Sexually Transmitted Infections (STIs): Awareness and prevention are essential. Regular screenings, safe sex practices, and vaccinations (like HPV) are crucial for maintaining sexual health.

The Role of Lifestyle in Sexual Health

1. Diet and Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can enhance overall health and improve sexual function. Foods high in antioxidants, like berries and nuts, can also boost circulation and hormone levels.

2. Exercise: Regular physical activity not only improves cardiovascular health but also increases testosterone levels and boosts mood. Aim for a mix of aerobic and strength training exercises for optimal benefits.

3. Mental Health: Psychological factors play a significant role in sexual health. Stress, anxiety, and depression can negatively impact libido and sexual performance. Seeking therapy or practicing mindfulness techniques can be beneficial.

4. Sleep Quality: Adequate and quality sleep is essential for hormonal balance and overall well-being. Establishing a regular sleep schedule and creating a restful environment can improve sleep quality.

Communication and Sexual Health

Open communication with partners about sexual health is vital. Discussing preferences, concerns, and health issues can foster intimacy and understanding, leading to a healthier sexual relationship. Additionally, having regular conversations about sexual health with healthcare providers can help men stay informed and proactive.

Seeking Help

Men should not hesitate to seek help for sexual health issues. Consult a healthcare professional for guidance, diagnosis, and treatment options. Early intervention can lead to better outcomes and improved quality of life.

Conclusion

Male sexual health is a multifaceted aspect of overall wellness that deserves attention and care. By understanding common issues, embracing a healthy lifestyle, and fostering open communication, men can enhance their sexual health and lead fulfilling lives. Remember, prioritizing sexual health is not just about addressing problems; it’s about celebrating and enjoying a vital part of human experience.

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Urologists located in Mesa, AZ

Arizona NanoKnife for Prostate Cancer

Arizona Urologic NanoKnife for Prostate Cancer

The NanoKnife provides a more localized treatment therapy that is targeted for the eradication of prostate cancer. As a leader in Urologic care for Arizona, EVU Center of Mesa and Queens Creek, we are excited to provide this wonderful new treatment option for our patients suffering with prostate cancer issues.

Nanoknife is a painless and minimally invasive surgical technique used in the treatment of prostate cancer. This type of therapy is focused on treating one focused area,rather than a whole section of the body. The NanoKnife System uses a technology called Irreversible Electroporation (IRE) to ablate, or destroy, targeted areas of prostate tissue.

The Nanoknife IRE has a 97% effectiveness in the eradication of the index lesion of the prostate. There is a < 20% recurrence rate in the rest of the prostate at five years of follow-up.

After enough pulses are delivered to the affected areas, the cells initiate a process that mimics apoptosis or natural cell death. The body responds to the apoptotic-like cell death by initiating the removal of cellular debris.

What To Expect During The Procedure

The procedure is performed percutaneously* or open, depending on the preference of your physician. Before the procedure begins, you will be sedated and remain sedated until the procedure is complete.

During the procedure, your physician will place the electrodes to bracket the targeted tissue. The number of electrodes used can range from 2 to 6, which is determined by your physician before treatment.

Once the electrodes are placed, your physician will initiate a series of electrical pulses.

The voltage used and time of the procedure are determined by your physician before treatment.

After your physician has delivered a sufficient number of pulses to the targeted area,

the procedure is complete, and the electrodes are removed. Post-procedure recovery is discussed with your physician.

Contact EVU Center to schedule a personal and private consultation

Patient Profile Using Nanoknife Treatment

Your Treatment. Reimagined.

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Urologists located in Mesa, AZ

Arizona Male Infertility Causes, Symptoms and Cures

Symptoms of Male Infertility

Male infertility often does not present obvious physical symptoms, making it essential for men to be aware of potential signs. Common indicators include:

  1. Changes in Sexual Function:
    • Difficulty achieving or maintaining an erection (erectile dysfunction).
    • Reduced libido or sexual desire.
  2. Semen Quality:
    • Changes in the volume, consistency, or color of ejaculate.
    • Presence of blood in the semen.
  3. Hormonal Symptoms:
    • Development of breast tissue (gynecomastia).
    • Decreased facial or body hair.
  4. Testicular Issues:
    • Pain, swelling, or lumps in the testicular area.
    • A noticeable reduction in testicle size.

If you notice any of these symptoms, it’s important to consult a healthcare professional for a thorough evaluation.

Diagnosis of Male Infertility

To determine the underlying causes of male infertility, healthcare providers may conduct several tests, including:

  • Semen Analysis: This test evaluates sperm count, motility (movement), morphology (shape), and overall semen quality.
  • Hormonal Testing: Blood tests can check hormone levels that regulate sperm production.
  • Genetic Testing: Chromosomal analysis may be recommended to rule out genetic disorders.
  • Imaging Studies: Ultrasounds or other imaging techniques can identify structural problems or obstructions.

Cures and Treatment Options for Male Infertility

The approach to treating male infertility depends on the underlying cause. Here are some common treatment options:

  1. Lifestyle Modifications:
    • Weight Management: Achieving a healthy weight can improve hormonal balance and sperm health.
    • Diet and Exercise: A balanced diet rich in antioxidants and regular physical activity can enhance fertility.
    • Avoiding Toxins: Reducing exposure to harmful chemicals and heat can support sperm production.
  2. Medications:
    • Hormonal Therapy: Hormone replacement or medications may be prescribed to address hormonal imbalances.
    • Antibiotics: If an infection is identified, antibiotics may be necessary to treat it.
  3. Surgical Options:
    • Varicocele Repair: Surgical intervention can correct varicoceles, improving sperm quality and production.
    • Obstruction Surgery: Surgical procedures may be needed to remove blockages in the reproductive tract.
  4. Assisted Reproductive Technologies (ART):
    • Intrauterine Insemination (IUI): Sperm is directly placed into the uterus during ovulation.
    • In Vitro Fertilization (IVF): Eggs are fertilized with sperm in a lab, and the resulting embryos are implanted in the uterus.
    • Intracytoplasmic Sperm Injection (ICSI): A single sperm is directly injected into an egg, often used in conjunction with IVF for severe male infertility.
  5. Sperm Retrieval Techniques:
    • In cases where sperm production is low or absent, techniques like testicular sperm extraction (TESE) can retrieve sperm directly from the testicles for use in IVF.

Conclusion

Male infertility is a complex issue with numerous potential causes and solutions. Recognizing the symptoms and seeking timely diagnosis can significantly improve the chances of successful treatment. If you suspect you may be experiencing infertility, don’t hesitate to contact an EVU Center urology specialist! With the right approach, many men beat the challenge of infertility and achieve their dream of becoming fathers.

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Urologists located in Mesa, AZ

Best Time for a Vasectomy Reversal and How It Works in Arizona

The Best Time for a Vasectomy Reversal and How It Works

A vasectomy is often considered a permanent solution for male contraception, but life circumstances can change, leading some men to seek a reversal. Vasectomy reversal is a surgical procedure that reconnects the vas deferens to restore fertility. However, timing plays a crucial role in the success of the procedure. Understanding the best time for a vasectomy reversal and how it works can help men make informed decisions about their reproductive health.

When Is the Best Time for a Vasectomy Reversal?

The success of a vasectomy reversal largely depends on the amount of time that has passed since the original vasectomy. While reversals can be performed years or even decades after a vasectomy, the chances of success generally decrease as more time passes. Here’s a breakdown of factors related to timing:

  1. Within the First 10 Years:
    • The best window for a vasectomy reversal is typically within 10 yearsof the original procedure.
    • Studies show that the success rate of restoring sperm to the semen is 75-97%when the reversal is performed within this timeframe.
    • The likelihood of pregnancy is also higher in this period, ranging from 50-75%.
  1. After 10 Years:
    • While success is still possible, the chances of achieving a successful reversal decline after 10 years.
    • Success rates for restoring sperm drop to around 30-60%, and pregnancy rates decrease to 30-40%or lower.
    • Over time, blockages can develop in the epididymis (a tube where sperm matures), and the quality of sperm may diminish, reducing fertility potential.
  1. Other Timing Factors:
    • Age of the Male Partner: Men can often produce sperm throughout their lives, but sperm quality may decline with age, especially after 50.
    • Age of the Female Partner: Fertility in female partners typically declines after age 35, which can also influence the success of achieving pregnancy after a reversal.
    • Health and Lifestyle: The sooner a vasectomy reversal is performed, the less likely complications like scarring or additional blockages will affect the reversal.

For the best chances of success, consult with a urologist or fertility specialist at EVU Center as soon as possible after deciding to pursue a vasectomy reversal.

How Does a Vasectomy Reversal Work?

A vasectomy reversal is a microsurgical procedure that reconnects the vas deferens, the tubes that were cut or blocked during the vasectomy. The goal is to allow sperm to flow from the testes into the semen again. The procedure involves two main techniques, depending on the condition of the vas deferens and whether any blockages have formed.

1. Vasovasostomy

  • How It Works: In this procedure, the surgeon reconnects the two ends of the vas deferens that were cut during the vasectomy.
  • When It’s Used: A vasovasostomy is performed when the vas deferens is free of blockages and sperm is present in the fluid near the site of the vasectomy.
  • Outcome: This is the simpler and more common type of reversal, with higher success rates when performed shortly after the vasectomy.

2. Vasoepididymostomy

  • How It Works: This procedure is more complex and involves connecting the vas deferens directly to the epididymis, the tube where sperm is stored and matures.
  • When It’s Used: A vasoepididymostomy is performed when blockages are found in the epididymis, often caused by scarring or inflammation from the original vasectomy or from a long delay before reversal.
  • Outcome: While more challenging, a vasoepididymostomy can still be highly effective, especially in cases where a vasovasostomy is not viable.

The surgeon decides during the procedure which technique to use based on the condition of the vas deferens and the presence of sperm in the fluid.

The Procedure and Recovery

  • Anesthesia: The procedure is usually performed under general or local anesthesia.
  • Duration: It takes about 2-4 hours, depending on the complexity of the surgery.
  • Recovery: Most men can return to light activities within a few days and resume normal activities within 2-3 weeks. Sexual activity is usually safe after 2-4 weeks, but your doctor will provide specific recommendations.
  • Follow-Up: A semen analysis is performed about 6-12 weeks after the procedure to check for the presence of sperm and assess fertility.

Success Rates and Considerations

The success of a vasectomy reversal depends on several factors:

  • Time Since Vasectomy: The less time that has passed, the better the odds of success.
  • Surgical Technique: The skill and experience of the surgeon play a significant role in the outcome.
  • Health of Both Partners: General health, lifestyle, and age can influence fertility and pregnancy success.

Even if sperm is not successfully restored to the semen, there are alternative options such as sperm retrieval combined with in-vitro fertilization (IVF) to achieve pregnancy.

Conclusion

The best time for a vasectomy reversal is ideally within 10 years of the original vasectomy, as the chances of restoring fertility are highest during this period. However, advancements in microsurgical techniques mean that successful outcomes are still possible even after longer intervals. If you’re considering a vasectomy reversal, consult with a skilled urologist who can evaluate your specific situation and recommend the best course of action. With proper timing and expert care, a vasectomy reversal can help restore fertility and open the door to new possibilities for building a family.

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Urologists located in Mesa, AZ

The Hidden Dangers of Peyronie’s Disease Arizonia

What Is Peyronie’s Disease?

Peyronie’s Disease occurs when scar tissue, known as plaques, forms under the skin of the penis. This scar tissue can cause the penis to bend or curve during erections. While some degree of curvature can be normal, Peyronie’s Disease often results in a painful and significant bend, which can lead to functional issues and emotional stress. The exact cause isn’t fully understood, but it’s often linked to trauma or injury to the penis, though it can also occur without any clear reason.

Failure to discuss by many men, causes this disease to go underrepresented. This is why the hidden dangers can affect various aspects of life, including physical health, sexual relationships, and mental well-being.

The Hidden Dangers of Peyronie’s Disease

Peyronie’s Disease is a medical condition that many men may not feel comfortable discussing openly, but its consequences can extend far beyond the obvious physical symptoms. While it’s often perceived simply as a condition causing curvature of the penis, the hidden dangers associated with Peyronie’s Disease can have profound effects on both physical and mental well-being. Understanding these risks is critical for those who may be affected and for promoting awareness about the importance of early diagnosis and treatment.

1. Chronic Pain and Physical Discomfort

Men with Peyronie’s Disease experience chronic pain, even when the penis is not erect. This discomfort can interfere with daily life, making simple activities like exercise or sitting uncomfortable. For some, untreated Peyronie’s Disease may worsen over time, leading to increased pain and a more pronounced curvature.

2. Reduced Sexual Function and Performance

One of the most significant dangers of Peyronie’s Disease is its impact on sexual function. The curvature and associated pain may make sexual intercourse difficult or even impossible. In some cases, Peyronie’s leads to erectile dysfunction (ED) due to the inability of the penis to maintain rigidity or the fear of pain during intimacy. This can result in frustration, anxiety, and a lack of confidence in sexual relationships.

3. Emotional and Psychological Impact

The psychological toll of Peyronie’s Disease is often underestimated. Men with this condition frequently report feelings of shame, embarrassment, and inadequacy. The visible curvature and difficulty with sexual performance can lead to anxiety and depression, especially if patients feel unable to discuss their condition with others. The stigma and lack of awareness about Peyronie’s Disease can further isolate those affected, reducing their willingness to seek professional help.

4. Strained Relationships

The emotional and sexual challenges of Peyronie’s Disease can have a ripple effect on intimate relationships. Partners may misinterpret the patient’s withdrawal as a lack of interest or affection, leading to misunderstandings. Left unaddressed, Peyronie’s Disease can significantly strain even the strongest relationships, creating an emotional divide between partners.

5. Risk of Worsening Symptoms

Without treatment, Peyronie’s Disease can progress. Over time, the scar tissue may harden, causing the curvature to become more severe. This can lead to additional complications, such as penile shortening and worsening erectile dysfunction. Early intervention is key to preventing these outcomes.

6. Links to Other Health Conditions

Peyronie’s Disease is sometimes associated with other health conditions, such as Dupuytren’s contracture (a hand condition that causes fingers to bend inward) or systemic vascular diseases. Men with Peyronie’s Disease may also be at higher risk for certain metabolic conditions, including diabetes and cardiovascular disease. This highlights the importance of a thorough medical evaluation for anyone experiencing symptoms.

What Can Be Done?

The good news is that Peyronie’s Disease is treatable, especially when detected early. Depending on the severity of the condition, treatments may include:

  • Medications:Oral drugs, injectable therapies, or topical treatments can help reduce plaque formation and pain.
  • Non-Surgical Therapies:Devices like penile traction therapy can improve curvature over time.
  • Surgery:In severe cases, surgical options can correct curvature and restore function.

Additionally, counseling or therapy can help address the emotional and psychological impact of the condition, improving the overall quality of life for patients and their partners.

Breaking the Stigma

One of the most significant challenges surrounding Peyronie’s Disease is the stigma and lack of awareness. Many men suffer in silence, either out of embarrassment or a mistaken belief that their condition is untreatable. It’s essential to break the silence and encourage open conversations about Peyronie’s Disease to ensure that individuals feel empowered to seek help.

Conclusion

Peyronie’s Disease is more than just a physical condition; it carries a host of hidden dangers that can profoundly affect a person’s physical, emotional, and relational health. By recognizing these risks and seeking early intervention, men can regain control of their lives and relationships. If you or someone you know may be experiencing symptoms of Peyronie’s Disease, don’t hesitate to reach out to a medical professional. There is help available, and no one should have to face this condition alone. Contact EVU Center to receive a complete diagnosis and treatment today.

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Urologists located in Mesa, AZ

Understanding Male Hypogonadism: Causes, Symptoms, and Treatment

Male hypogonadism is a condition where the body doesn’t produce enough testosterone, the primary male sex hormone. This can lead to a range of physical and emotional changes, impacting overall quality of life.

Causes:

Hypogonadism can stem from problems in the testicles (primary hypogonadism) or issues with the hypothalamus and pituitary gland in the brain (secondary hypogonadism).

  • Testicular Issues:
    • Undescended testicles
    • Injury or infection
    • Chemotherapy or radiation
    • Genetic conditions (Klinefelter syndrome)
  • Hypothalamus/Pituitary Issues:
    • Tumors
    • Medications
    • Obesity
    • Aging (age-related decline in testosterone)

Symptoms:

The symptoms can vary depending on the age of onset and severity of the condition.

  • In Adolescents:
    • Delayed puberty (lack of facial hair, deep voice, muscle development)
    • Reduced growth of penis and testicles
    • Excessive breast growth (gynecomastia)
  • In Adults:
    • Low sex drive
    • Erectile dysfunction
    • Decreased energy and fatigue
    • Loss of muscle mass and strength
    • Increased body fat
    • Depression and mood swings
    • Difficulty concentrating
    • Hot flashes
    • Sleep disturbances

Diagnosis:

Diagnosis involves a combination of:

  • Physical examination:To assess physical signs and symptoms.
  • Blood tests:To measure testosterone levels, typically checked in the morning when levels are highest.
  • Additional tests:Depending on the suspected cause, further tests may include semen analysis, genetic testing, pituitary imaging, or testicular biopsy.

Treatment:

The primary treatment for male hypogonadism is testosterone replacement therapy (TRT). This aims to restore testosterone levels to a normal range and alleviate symptoms. TRT is available in various forms:

  • Skin gels:Applied daily to clean, dry skin.
  • Injections:Administered intramuscularly every 1-2 weeks or longer-acting injections every 10 weeks.
  • Patches:Applied to the skin, releasing testosterone over 24 hours.
  • Pellets:Implanted under the skin, releasing testosterone gradually over several months.
  • Buccal tablets:Placed between the gums and cheek, absorbed through the oral mucosa.

Other Treatments:

  • Treating underlying conditions:If an underlying medical condition is causing hypogonadism, treating that condition may improve testosterone levels.
  • Lifestyle changes:Maintaining a healthy weight, regular exercise, and a balanced diet can support overall hormonal balance.
  • Counseling or therapy:May be beneficial for addressing emotional and psychological effects of hypogonadism.

Important Note: TRT is not suitable for everyone, and potential side effects and risks need to be discussed with a healthcare provider. Regular monitoring is essential to ensure treatment effectiveness and safety.

If you suspect you may have hypogonadism, consult one of our healthcare providers for a proper evaluation and personalized treatment plan.

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Urologists located in Mesa, AZ

Nanoknife for Prostate Cancer Arizona

Urologists located in Mesa, AZ

Step Inside IRE Technology.

Precision Empowered.

  • Sculpt and control ablation zone through multiple electrode configurations6
  • IRE effectively destroys targeted tissue giving you precise treatment margins resulting in confident treatment coverage4,7
  • Sharp demarcation of IRE-ablated zone is well-visualized using real-time ultrasound5

Preservation Redefined.

  • Spares vital structures by retaining the functional anatomy of the targeted tissue.8,9
  • Preserves the extra-cellular matrix, facilitating post-ablation, histological and functional tissue regeneration.8,9

Versatility Perfected.

  • IRE treatment can be confidently delivered in all segments of an organ.8
  • Electrodes can be confidently placed near vital structures, maximizing your ability to personalize treatment to your patient’s anatomy. 9
 

Designed for Performance.

Hover over icons below to discover features.

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Urologists located in Mesa, AZ

Rezum Water Vapor Therapy

Urologists located in Mesa, AZ

TMBS E269: Dr. Rahul Mehan – Rezūm™ Water Vapor Therapy

At last an answer for men over 60 that suffer prostatic hyperplasia (BPH) enlarged prostate conditions. Dr. Rahul Mehan is Mark’s guest for this episode sharing this incredible non-surgical water vapor therapy called Rezūm™ Water Vapor Therapy.

Overview of the #Rezum Water Vapor Therapy

Dr. Rahul Mehan

https://www.iheart.com/podcast/53-the-mark-bishop-show-82657128/episode/tmbs-e269-dr-rahul-mehan–103504451/ – October 19, 2022 • 10 mins

Rezūm™ Water Vapor Therapy is a non-surgical treatment for men 50 years or older that can be performed in a doctor’s office. Rezūm Therapy uses the energy stored in water vapor to reduce the size of the prostate, providing lasting BPH symptom relief while preserving sexual and urinary function.[v] Patients who receive Rezūm Therapy can typically resume normal activities within a few days after treatment and most patients see symptom improvement within two weeks.5

For more information please visit: www.rezum.com

[i] Interviews represent a collaborative education activity between Dr. Rahul Mehan and Boston Scientific Corporation. Physicians are not compensated for his time.

[ii] Harvard Health. The growing problem of an enlarged prostate gland. Available at: https://www.health.harvard.edu/mens-health/the-growing-problem-of-an-enlarged-prostate-gland.  Accessed July 2022.

[iii] Mayo Clinic. Benign prostatic hyperplasia. Available at: https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087. Accessed July 2022.

[iv] Gupta N, Rogers T, Holland B, et al. Three-Year Treatment Outcomes of Water Vapor Thermal Therapy Compared to Doxazosin, Finasteride and Combination Drug Therapy in Men with Benign Prostatic Hyperplasia: Cohort Data from the MTOPS Trial. J Urol. 2018 Aug;200(2):405-413.

[v] McVary KT, Gittelman MC, Goldberg KA, et al. Final 5‐year outcomes of the multicenter randomized sham‐controlled trial of Rezūm water vapor thermal therapy for treatment of moderate‐to‐severe lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2021 Sep;206(3):715‐24.

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Urologists located in Mesa, AZ

Greenlight After Urolift

Urologists located in Mesa, AZ

Urologists Dr. David Robbins, Dr. Ricardo Gonzalez and Dr. Rahul Mehan provided their perspectives and experiences when using the GreenLight XPS™ Laser Therapy System for patients requiring further intervention following a UroLift™ procedure. The UroLift System is commonly used to treat benign prostatic hyperplasia (BPH) and involves the use of implants to hold open the obstructed pathway blocking urine flow. UroLift offers rapid and significant improvements in symptoms, urinary flow and quality of life sustained through five years, and patients can preserve sexual function.1 UroLift is indicated for the treatment of symptoms due to urinary outflow obstruction secondary to BPH, including lateral and median lobe hyperplasia, in men 45 years of age or older. It is contraindicated for patients with a prostate volume of >100 cc. The American Urological Association (AUA) Guidelines recommend UroLift for patients with Lower Urinary Tract Symptoms (LUTS)/BPH with prostate volume 30-80 cc and verified absence of an obstructive middle lobe.2 In some cases, patients experience a reoccurrence of symptoms and require further treatment to manage their BPH. In the pivotal trial, UroLift patients had a 13.6% surgical retreatment rate and 10.7% medical retreatment rate at five years.1 Therapy with GreenLight is proven to effectively and safely treat a broad spectrum of BPH patients, including those at high risk (e.g., larger prostate, older age, greater comorbidities) and on anticoagulants, while providing long-term durability, reduced bleeding, and shorter hospitalization and catheter times as compared to transurethral resection of the prostate (TURP).3-5 GreenLight provides durable results and symptom relief for patients.6 According to the Instructions for Use for both devices, following are important considerations for both treatments:
What goes into patient selection for UroLift, and why might patients choose UroLift for BPH?
Dr. Mehan: There are many reasons why patients would choose UroLift to treat their BPH, including that it can be performed in the office under local anesthesia and the return to normal voiding is rapid.2 Additionally, sexual function is preserved, and symptom improvement is rapid and significant. Finally, there is minimal risk with the procedure, and it doesn’t negate the option for future treatment options if they are needed.2 Typically, optimal patient candidates for UroLift have a prostate volume of less than 80 cc when not on medical therapy, with International Prostate Symptom Score (IPSS) ≥ 12 with associated bother, and a Qmax (peak flow rate) less than 15 mL/s.1 Dr. Robbins: When I’m choosing patients for BPH surgery, I find out what their goals and needs and wants are as far as ejaculatory maintenance. Additionally, I assess their physical condition to determine key factors such as how much obstruction they have, how big their prostate is, what does the bladder look like, do they have a median lobe, etc. For a UroLift candidate, I’m looking for smaller prostates, and patients who are not in retention and are interested in ejaculatory preservation.2
How often are you seeing patients in your practice require intervention following treatment with UroLift?
[In the pivotal trial, UroLift patients had a 13.6% surgical retreatment rate and 10.7% medical retreatment rate at five years.1 Dr. Gonzalez: I specialize in voiding dysfunction, and I see men who need treatments for their BPH daily – between 8 and 10 per week. Of these patients, one or two are candidates for minimally invasive surgical therapy (MIST) procedures in my particular practice. I usually treat at least one patient a week who has had prior UroLift intervention and, for those, I tend to do laser procedures. It allows me more versatility because I can treat different shapes and morphologies of prostates, and I tend to lean on those therapies for most men. I do not feel that UroLift is necessarily a bad option, but it may have been too little too late for these particular patients, and not enough to solve their problem.
What are the symptoms patients present with prior to reintervention?
Dr. Gonzalez: My patients who present with prior UroLift and now are considering reintervention generally are doing so because either their original symptoms persist or they appear to have been exacerbated. Some examples include patients who have smaller prostates that might have primary bladder neck obstruction or a puckered appearance of the bladder neck. Other patients present because the degree of improvement that they experience was not to their expectation or was not good enough to allow them to be able to stop medical therapy. Dr. Robbins: I don’t see a lot of patients who have had UroLift and who have major complications from the implants. Some patients just don’t have the relief that they expected they would have. They’re continuing to have the typical BPH symptoms of urinary urgency, frequency, they’re waking up at night, they’re straining to urinate.
Why do you choose to use GreenLight for a UroLift patient requiring reintervention?
Dr. Mehan: I absolutely love utilizing GreenLight for UroLift re interventions. It is the most versatile treatment option I offer in my practice. It allows me to open the central tissue and better address the lateral lobes. I can also take down high riding bladder necks or median bars very easily and efficiently. From a patient standpoint, it avoids the risks of erectile dysfunction as seen with the TURP procedure.4 Also, with the ejaculatory hood sparing technique, ejaculatory function can better be preserved.9 Dr. Gonzalez: What I love about GreenLight is the versatility of the laser. With that single laser technology, I can do a simple incision of the prostate. I can vaporize the prostate or perform an enucleation of the prostate with a safe technology that minimizes bleeding.3 When I have a patient who has a tight bladder neck or high median bar, and who hopes to preserve as much ejaculatory function as possible, making an incision of the prostate with GreenLight is effective and can have an antegrade ejaculation rate of 85%.10 In patients who have bulky obstruction by the lateral lobes, photo-selective vaporization (PVP) and enucleation techniques along with vaporization incision technique (VIT) with GreenLight allows resection of the obstructing tissue as well as the UroLift clips, and allows us to remove the obstruction, thereby improving the patient’s ability to void the bladder, and impact their quality of life.4 Also, in patients who had an obstructing median lobe, you can enucleate the median lobe and enucleate the lateral lobes. Or you can enucleate the median lobe and vaporize the lateral lobes. The benefit is that the same laser allows you to employ different techniques where needed within the prostate. And these techniques are not solely exclusive. For example, one man may only have vaporization or one man may only have enucleation. In the same patient you can enucleate one lobe, but vaporize two lobes, or enucleate two lobes and vaporize one lobe. GreenLight is versatile enough that it lets you employ the technique you need to solve the problem, and I think of it as my Swiss Army knife in my arsenal for BPH. And not only allowing me to treat different shapes and sizes, but also higher risk men who are perhaps anticoagulated or who are just delicate enough that I would not want to do a type of procedure like a TURP where the patient might need to stay the night in the hospital.5 As much as possible, I really want to do day surgery and have a patient go home the same day to keep them out of the hospital. In the U.S., GreenLight can be a same-day procedure.11 This helps to avoid exposing them to risks that may be inherent from a hospital stay, but also keeps us from using hospital resources that we don’t have to use. Dr. Robbins: GreenLight is a great solution because here in the U.S., it can be a day surgery procedure with minimal catheterization time, bleeding and recovery.11,12 Additionally, with GreenLight you can remove the UroLift implants. As a treatment in and of itself, GreenLight is really definitive – you can actually take away or vaporize the majority of the obstructing tissue. You can remove the median lobe and the UroLift implants and create a nice open channel for the patient to void through and have significant relief of their symptoms.
GreenLight7
The GreenLight Laser System is intended for incision/excision, vaporization, ablation, hemostasis, and coagulation of soft tissue, including photoselective vaporization of the prostate for benign prostatic hyperplasia (BPH). The laser system is contraindicated for patients who are: contraindicated for surgery, contraindicated where appropriate anesthesia is contraindicated by patient history, have calcified tissue, require hemostasis in >2mm vessels, have uncontrolled bleeding disorders, have prostate cancer, have acute urinary tract infection (UTI), or severe urethral stricture. Possible risks and complications include, but are not limited to, irritative symptoms (dysuria, urgency, frequency), retrograde ejaculation, urinary incontinence, erectile dysfunction, hematuria – gross, UTI, bladder neck contracture/outlet obstruct, urinary retention, perforation – prostate, urethral stricture.
UroLift8
The UroLift System is indicated for the treatment of symptoms due to urinary outflow obstruction secondary to benign prostatic hyperplasia (BPH), including lateral and median lobe hyperplasia, in men 45 years of age or older. The UroLift System should not be used if the patient has: a prostate volume of >100 cc, a urinary tract infection, urethral conditions that may prevent insertion of delivery system into bladder, urinary incontinence due to incompetent sphincter or current gross hematuria. Possible risks and complications include, dysuria, hematuria, pelvic pain, micturition urgency, urinary incontinence, calculus urinary, retention, nocturia, pollakiuria, bladder spasm, blood clot in urine, urge incontinence and painful ejaculation.
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Urologists located in Mesa, AZ

How To Choose The Right Urologist

Choosing the right urologist is an important step for anyone dealing with a urological problem. Urologists are medical professionals who specialize in the diagnosis and treatment of diseases of the urinary tract and male reproductive organs. Here are some tips to help you choose the best urologist for your needs:

  1. Check their credentials: Make sure that the urologist you are considering is certified by the American Board of Urology and has the necessary qualifications to provide quality care.
  2. Consider their experience: Urologists have different levels of experience. Ask about the doctor’s experience in treating similar conditions to yours.
  3. Ask questions: Make sure to ask questions about the doctor’s approach to treatment and management of your condition. Be sure to get a clear understanding of the options available to you.
  4. Ask for referrals: Ask your primary care physician or specialist for referrals to urologists they may recommend.
  5. Get a second opinion: If you are unsure about the diagnosis and treatment plan, it is always a good idea to get a second opinion from another urologist.

By following these tips, you can ensure that you find the best urologist for your needs.