Green light laser technology is the final process that starts with urinary symptoms. When untreated an enlarged prostate can completely shut down the urethra and stop urine from leaving the bladder. When this happens, men end up going to the emergency room and have a catheter (latex tube) placed in their bladder. While this may sound extreme it is very much welcomed by the patient because bladder obstruction is a very painful experience. The minute the catheter is placed in the bladder all of the pain goes away. When the urine backs up in the bladder there is a chance that it can go back up to the kidney and if this occurs, permanent damage may ensue. The kidney and occasionally even both kidneys may expand and become deformed from the pressure of the urine backing up. The connection of the kidney to the ureters is very susceptible to deformity and becoming disconnected. When this does occur Dr Bianco may perform a pyeloplasty with the da Vinci robotic system. Of course the worst scenario is that the kidney may be damaged to the point that it will never work again.

When the prostate is very large it may need to be removed entirely and Dr Bianco will perform a prostate removal surgery with a
da Vinci prostatectomy. Here is the robot peeling a grape.  

Green light laser technology is spreading to more and more surgeons that are using it as their go to tool in overcoming benign prostatic hyperplasia. Our Miami urology team also makes sure that cancer is not the cause of excessive prostate tissue. In the prostate exam many attributes are looked at to get to your diagnosis of benign prostatic hyperplasia. A digital rectal exam is performed to feel for any prostate nodules or the expansion of the prostate on only one side (asymmetric growth). The family history is also taken into account. Recently personal genomes have become available and the price is only a couple of hundred dollars. As population studies of men with prostate cancer are analyzed in greater numbers the specific combinations of genes that cause prostate cancer will give us the ability to indicate those with a higher than normal chance  of getting prostate cancer.  These and many other biomarkers are and will be used in your personal prostate cancer risk assessment. These personal genome test kits or personal exome kits show us portions of genes in the genome that are actually turned into proteins (expressed) they are called exons.

The prostate specific antigen (PSA) test is another biomarker that is also used by urologists. This test is a blood test that has been used by doctors to help determine your chance of prostate cancer as you become older. Some doctors claim that the PSA test results are not accurate enough to be used as an indicator for prostate cancer. Also different PSA tests are being tried to show more relevancy toward the diagnosis of prostate cancer. These claims and new approaches are what the medical community does until a consensus is formed or a new methodology or technology gives us a better way. Columbia University Division of Urology is always at the forefront helping to optimize medicine.