NEW THERAPY FOR PROSTATE ENLARGEMENT

A new procedure for reducing prostate enlargement has been developed by urologist and researcher Joseph V. DiTrolio, MD. Quicker, less painful, and cheaper than traditional surgical procedures, it is currently being tested at a dozen medical centers around the country.

The technique, called chemical ablation of the prostate, utilizes an ingenious device called an InjecTx to inject alcohol into the enlarged gland. The InjecTx was invented by DiTrolio, who is assistant professor of urology at UMDNJ-New Jersey Medical School. It is a customized version of the cystoscope bridge, used by urologists to look inside the bladder. The InjecTx has a long deployable needle which fits within the cystoscope sheath. The sheath is inserted into the penis and threaded through the urethra, toward the prostate. When it reaches the prostate, the scope is rotated 90 degrees to the right or left. The needle is then pushed into the prostate and a small amount of purified alcohol is injected. The alcohol passes into prostate cells, which then absorb water to dilute the alcohol. Eventually, the cells take in so much water that they burst. The prostate shrinks as the burst cells are eliminated.

Half of all men over the age of 50 suffer from prostate enlargement. Though not related to cancer, this condition causes frequent urination and difficulty emptying the bladder, and requires surgery, medication or other treatment in one-fourth of men by age 80. Blocked urine can damage the bladder and kidneys. In rare cases, it is fatal.

Traditional surgery for prostate enlargement is expensive ($10,000 for most procedures) and painful, and usually requires a hospital stay and catheterization for up to seven days. Chemical ablation of the prostate can be performed in about a half hour under either a local anesthetic or a small amount of intravenous sedative. The cost is approximately $1,000, and no antibiotics are required. The patient is catheterized for two days.

DiTrolio had tested the procedure on ten patients scheduled for prostate surgery. In nine of them, the prostate size was reduced without side effects. The tenth patient felt better and voided well, but did not have documentable shrinkage of the prostate. The patients have been followed for only six months, so further study is needed to prove that side effects won't develop later on, or that the prostate won't enlarge again and require further treatment.

“The InjecTx may very well become the definitive treatment for prostate enlargement,” says DiTrolio. “More than 30 procedures have been performed thus far, and that number is rapidly increasing.”

The InjecTx will be available for sale in January through ProSurg, a California-based technology company. The use of alcohol in the body and all the components of his device have already been approved by the Food and Drug Administration. DiTrolio presented his findings at the American Urological Association's annual meeting in May.