BPH Patient Education Seminar - PowerPoint Presentation

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BPH Patient Education SeminarLearn about Enlarged Prostate Solutions

Presented by

{Physician Name}Slide2

Understanding the ProstateBladder

Urethra

Pubic Bone

Testes

Penis

Rectum

ProstateSlide3

Common Symptoms of Prostate DisordersIncreased frequency of urination especially at nightSudden or urgent need to urinatePainful or difficult urinationSlow flow of urine and difficulty in stopping Terminal dribbling or leakingIncomplete emptying of the bladderSlide4

Protecting Your ProstateHigh levels of stress, obesity cigarette smoking and inactivity have all been linked with increased risk of prostate disease1Reduce stressEat healthyKeep activeQuit smoking/tobacco useSlide5

Assessing Your Prostate HealthBegin regular prostate exams at age 50 (or sooner if you are experiencing symptoms or have high-risk factors)Know your Urology numbersAUASS is the American Urological Association Symptom Score demonstrates symptom severity of BPHProstate Specific Antigen (PSA) indicates issues with the prostate including cancer

Testosterone Level is central to a man’s sex drive, energy level, muscle strength and bone densitySlide6

Common DisordersProstatitis - Swelling or infection of the prostate glandLow Testosterone - decreased functional activity of the testesErectile Dysfunction – Inability to maintain an erection sufficient for satisfying sexual activityBenign Prostatic Hyperplasia

– Enlargement of the prostate glandProstate Cancer - Malignant (cancerous) cells form in the prostate tissueSlide7

Enlarged Prostate: Most Common ConditionBPH is in the top 10 of the most commonly diagnosed diseases in men over the age of 50250%+ of men in their 50s experience BPH symptoms390% of men in their 70s and 80s experience BPH symptoms

3Slide8

What is Benign Prostatic Hyperplasia(BPH)?Prostate cells begin to increase in numberCompresses the urethra making it difficult to urinateNot cancerous or life threatening

Can be very bothersome and impact quality of lifeCan progress to more serious conditionsVery common in men over 50 and advances with ageSlide9

Normal Male AnatomyBladder

Urethra

Prostate GlandSlide10

Male Anatomy with Enlarged ProstateBladder

Blocked Urethra

Enlarged Prostate GlandSlide11

BPH Signs and SymptomsWaking at night to urinateFrequent urinationSudden, uncontrollable urges to urinateStraining to start urinateWeak urine flowDribbling after urinationFeeling bladder is not completely emptyPain during urinationSlide12

Potential Medical Consequences of BPHUrinary retentionUrinary tract infectionsBladder stonesBlood in the urineIncontinenceDecreased kidney function

Derived from Benign enlargement of prostate. ADAM Health Illustrated Encyclopedia. www.healthline.com/adamcontent/enlarged-prostate. Accessed Oct. 21, 2010Slide13

Physician EvaluationPhysical examSymptom score rateUrinalysisSerum PSAFlow RatePost-Void ResidualSlide14

AUA GuidelinesPatient Assessment & Testing

Mild Symptoms?AUASS <= 7 Or Not Bothersome

Moderate/Severe Symptoms?

AUASS >= 9 or Bothersome

Discuss Treatment Options

Medical Therapy

In-Office Therapy

Surgery

Watchful WaitingSlide15

Treatment OptionsWatchful Waiting

Medication

In-Office Therapy

SurgerySlide16

Watchful WaitingSymptoms are fairly mild or not bothersomeOngoing assessments once or twice a yearMonitor symptom progressionCheck disease progressionCheck for infection and kidney/bladder stonesSlide17

Herbal SupplementsNot recommended by the American Urological Association4No evidence of efficacy4May increase your risk of bleeding or interfere with other medications you're taking4Most popular supplements

Saw palmetto extractBeta-sitosterol extractsPygeumRyegrass extractStinging nettle extractSlide18

Drug TherapyCommon OptionsAlpha-blockers (Cardura, Flomax)5-ARIs (Avodart, Proscar)

Combination Therapy (Jalyn)Drugs: Most Common Treatment Option94% of patients are treated with prescription medications, but 48% of patients do not show clinically significant symptom improvement5Slide19

Medication – Possible Side EffectsAlpha-Blockers5

ARIsReduced blood pressure

Headache

Nasal congestion

Pounding heartbeat

Nausea

Weakness

Weight gain

Floppy iris syndrome (IFIS)

Erectile

dysfunction

Lowered

sexual drive (libido)

Decrease

in semen released during ejaculation

Decrease PSA levels

Note:

This list represents the most commonly reported side effects. Please discuss any questions you may have with your physician. Your physician can also provide you with a comprehensive list of all potential side effects. Slide20

Drug Therapy AdvantagesSimple to useFast symptom relief (Alpha-blockers)Does not require surgery, anesthesia or a hospital stay (or associated side effects)Low rate of side effectsCovered by Medicare and many private insurance companiesSlide21

In-Office BPH TherapyCommon Options:Transurethral Microwave Therapy (TUMT) (Cooled ThermoTherapy)Targeted heat to reduce excess prostate tissue in large glands8Transurethral Needle Ablation (TUNA) (Prostiva RF Therapy)Precisely targeted low-level RF energy for small glands or atypical prostates9Slide22

During the TreatmentPre-procedure preparation 15-20 minutesMedications given for relaxation and comfortComfort levels are generally tolerable and reported between a 2-3 on a 10 point pain scale6New prostatic blocks being performed that may eliminate discomfort completelyProcedure time usually less than 30 minutesRecovery time generally 15-20 minutes and will include post treatment instructionsSlide23

After TreatmentGo home shortly after treatmentUrinary catheter or temporary stent may be required for a few days7,8Return to normal activities within 24-48 hours8,9Symptom improvement generally seen within 8 to 10 weeks of the treatment8,9Lasting and

significant relief from your symptoms6,7Slide24

In-Office Therapy AdvantagesVery effective at relieving symptoms6,7Proven long-lasting results6,7Can eliminate need for chronic medication

Lower risk than invasive surgical proceduresCompleted in urologist office in less than an hour - no hospitalization, general anesthesia or long recovery timeQuick return to normal activitiesLow rate of side effects8,9

Covered by Medicare and many private insurance companiesSlide25

In-Office Therapy – Possible Side EffectsTUMTTUNA

Hematuria

Dysuria

Blood in urine

Clots in urine

Painful or difficult urination

Rectal irritation

Temporary inability to control urination

Inability to discharge semen in orgasm

Brief inability to achieve or maintain an erection

Obstruction (blockage)

Bleeding

Blood in Urine

Pain/Discomfort

Urgency to Urinate

Increase Urinary Frequency

Urinary Tract Infection

Note:

This list represents the most commonly reported side effects. Most of these side effects were temporary or mild and required minimal or no medical intervention.

Please discuss any questions you may have with your physician. Your physician can also provide you with a comprehensive list of all potential side effects. Slide26

SurgeryCommon OptionsTransurethral Resection of the Prostate (TURP) Surgical removal of part of an enlarged prostate glandButton TURPProstate tissue removed through vaporizationLaser Photoselective

Vaporization (PVP or GreenLight) Holmium Laser Prostatectomy (HoLAP)A laser (concentrated light) is used to generate intense heat to shrink or remove excess tissueSlide27

Surgery AdvantagesImmediate symptom relief10,11Long history of success (TURP)Can eliminate need for chronic medicationCovered by Medicare and many private insurance companiesSlide28

Surgery Possible Risks/Side EffectsTURP10

LASER11

Anesthesia

issues

Intracapsular

perforation

TUR Syndrome

Transfusions

Post-op pain/discomfort

Infection

Retrograde

ejaculation

Erection problems

Painful Urination

Temporary

difficulty urinating

Urinary

tract infection

Narrowing

of the urethra

Retrograd

e Ejaculation

Erectile

Dysfunction

Please discuss any questions you may have with your physician. Your physician can also provide you with a comprehensive list of all potential side effects. Slide29

A Winning SolutionUrinary symptoms are a normal part of aging

There are treatment options that can help you restore your quality of life

If you are dissatisfied with your current therapy, please speak with your physician about what other therapies might be suited for youSlide30

Common QuestionsHow comfortable will I be during the procedure?Are the results long-lasting?Are the procedures covered by my insurance?Slide31

REMINDER: Complete and turn in the response cards!

For the Physician’s Office

For UrologixSlide32

Thank you!Slide33

Referenceshttp://www.umm.edu/patiented/articles/what_causes_cell_growth_leading_benign_prostatic_hyperplasia_000071_3.htm#ixzz2R79HHR4HFenter TC, Naslund MJ, Shah MB, et al. The cost of treating the 10 most prevalent diseases in men 50 years of age or older. Am J

Manag Care. 2006;12(4 suppl):S90-S98.National Institute of Diabetes and Digestive and Kidney Diseases. Prostate enlargement: benign prostatic hyperplasia. NIH Publication No. 07-3012. June 2006.http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027/DSECTION=alternative-medicine

Wei, et al. High Rates for Continued BPH Medical Therapy among Non responders, AUA2010 Abstract 498

Mynderse

, L., et al. 5 year Results of a Multi-Center Trial of a New Generation Cooled TUMT for BPH, J Urol. 2011; 185(5):1804-1810

Hill, B., et al. Transurethral Needle Ablation vs TURP for the Treatment of Symptomatic BPH: 5 Year Results of a Prospective, Randomized, Multicenter Clinical Trial, J Urol. 2004;171(6 Pt 1):2336-2340

Data derived from the CTC Advance® Instructions for Use, 250348 Rev D 08/10

Data derived from the Prostiva® RF Therapy System User Guide 8930 CRMRef_R06

American Urological Association Guideline: Management of Benign Prostatic Hyperplasia (BPH),

McVary

et al. Revised 2010

American Medical System Inc. website:

http://www.greenlightforbph.com/

MC1654 Rev D 08/14