An innovative procedure to treat symptoms of enlarged prostates provides men with a fast and relatively comfortable alternative to traditional prostate surgeries. The new procedure, which uses a permanent implant to open the prostate, was recently performed at Wilkes-Barre General Hospital, the first local hospital to complete it.
Dr. Michael Rittenberg, a urologist who practices in Kingston, completed three procedures using the UroLift System on Jan. 27. Before Rittenberg performed the procedure, the closest practicing specialist was in the Lehigh Valley. One week after the operations, all three patients reported improved urinary function, and Rittenberg believes the procedure will become widely used among men who need it.
"We're talking about men who have voiding dysfunction, inability to urinate normally," Rittenberg said. "The most common cause of that is a disease called BPH, or benign prostatic hyperplasia, which affects 50 to 75 percent of men over the age of 50."
The procedure uses a scope passed through the urethra to implant anchors, specifically designed medical staples, into the prostate. These implants hold swollen tissue out of the way, allowing urine to flow properly and reducing irritability, frequency, and urgency.
"It literally pulls the tissue aside, so my layman's analogy is like stapling the prostate open," Rittenberg said. "Another analogy is if you have curtains coming down from a curtain rod and you use a sash to pull them aside, creating a channel. The purpose here is to create a channel that allows the bladder to empty more efficiently."
Traditional surgery, transurethral resection of the prostate, remains a viable option depending on a patient's age, condition, and medical history. However, the UroLift System offers advantages that other methods do not. It is minimally invasive, recovery time is shorter, and tissue damage is limited. Patients can fully recover within one to two weeks, according to Rittenberg.
"The three patients believe that they are doing well and believe that they are improved compared to how they were before the procedure," the doctor said.
One patient, Warren Pollard of West Pittston, said he experienced some pain after the operation, but it lasted only about a day and a half, and he was able to return to his normal routine quickly.
"The operation was at 11 a.m. on a Wednesday," Pollard said. "Thursday morning, I walked six miles with no problem."
Pollard said he is experiencing very little discomfort and that his symptoms appear to be improving.
"I think the urine flow is better," he said.
Pollard also appreciated having the surgery performed close to home.
While Rittenberg was the first to perform the procedure in the region, he said he is confident that other urologists will adopt it over time.
"The first procedures were done under general anesthesia, but I ultimately foresee us using only IV sedation," Rittenberg said. "In reality, for some people this could eventually become a procedure done in the office using only local anesthesia."
Rittenberg said his goal is to provide a full range of services to his patients.
"I pride myself on being competent and experienced in all procedures that urologists perform," Rittenberg said. "Do people have to go out of town for any procedure? Not for urology procedures, because we do all of the latest procedures here. We have all of the latest equipment."
The long-term durability of the procedure will become clear over time, Rittenberg said, although his intention is always to treat a patient once.
"We're looking at a relatively short history of this procedure, but when you look at the goals and short-term outcomes, they are consistent with what we expect from traditional surgery," Rittenberg said. "In 10 years, we'll know whether any of these patients will need additional treatment. My hope is that they will not."
The UroLift implant is an expensive procedure. Without including anesthesia and operating room costs, the implant itself can cost between $3,400 and $5,100. However, Rittenberg said the procedure may offer financial advantages compared to other treatment options.
"I see a strong future for this procedure in an era focused on economics, cost control, and insurance limitations. Medications are extremely expensive," Rittenberg said. "Many men, when faced with taking one or two medications for the rest of their lives, may choose this procedure instead. Although it is expensive initially, it is a one-time treatment and then it is done."
Dr. Rittenberg has been featured in the Times Leader for performing the first UroLift procedure in the Northeast Pennsylvania area.