Ask Dr. Gott: Reader has questions about prostate treatment

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Updated: May 28, 2011 12:19AM

Q: My father is 93 years old. Owing to an enlarged prostate, he is not able to completely empty his bladder. He is feeling no pain and minimal discomfort from this condition. In fact, he feels it is more of a nuisance having to urinate frequently.

His urologist recommends GreenLight laser surgery to relieve the problem. He has been told that this condition, if left untreated, could lead to kidney problems and/or a blood infection. He is fearful that the surgery could lead to incontinence.

A: GreenLight vaporization of the prostate is a new, minimally invasive procedure used for treatment of benign prostatic hyperplasia (BPH), the most common cause of an enlarged prostate. A laser-light source and fiber-optic delivery system vaporizes and removes enlarged tissue in the prostate, resulting in immediate relief of symptoms. Urinary flow will improve, and a person will be able to empty the bladder with ease. This is a vast improvement over the “gold standard” trans-urethral resection procedure (TURP) with fewer side effects and faster recovery. Total recovery should take a few weeks following surgery. With GreenLight, a patient will arrive at a hospital, have the procedure, which takes less than an hour, and be discharged the same day. It is rather common to return home without catheter insertion. In instances when a catheter is inserted, it is removed within 24 hours.

If a procedure can be done in less time, with less bleeding, less trauma for the patient and faster recovery, I’m all for it. And, at 93, I am sure that your father would agree.

Q: I am a 74-year-old female retired radiologic technologist due for my annual screening mammogram in another month. My only significant breast history is the presence of a tiny cyst diagnosed on one side two years ago. Last year, my screening mammogram was normal.

Which is better/more accurate for me to have — the digital mammogram or the long-used film-screen mammogram, and why? .

A: Both methods use X-rays to produce images of the breast. While numerous “films” may be taken, they cannot be modified. With digitals, that information can be magnified, enhanced or manipulated for evaluation more easily than the information on a film.

The FDA approved digital mammography in 2000. A large clinical trial comparing digital to film mammography was published and failed to reveal differences in the detection of breast cancer in the women who participated. One interesting conclusion was that digital mammography was more accurate for pre- and peri-menopausal women and for women with dense breasts.