David Robbins, MD is a board certified urologist and specialist in the medical and surgical management of BPH or enlarged prostate. Dr. Robbins has extensive experience in the treatment of enlarged prostate conditions and urinary retention using the state of the art Green Light Laser XPS system. Using this technology Dr. Robbins is able to improve patients burdensome voiding symptoms including urinary urgency, frequency, night time frequency, incomplete emptying, slow stream and incontinence even for prostates that are considered by others to be too large for minimally invasive surgery. Using laser technology, without the need for a surgical incision, Dr. Robbins uses Green Light Laser technology to relieve prostate obstruction in under an hour without the need for an overnight hospital stay or prolonged catheterization. Unlike the traditional TURP procedure, Green Light Laser technology, in the capable hands of a renowned expert like Dr. David Robbins, does not result in blood loss and the need for a hospital stay and prolonged catheterization.
“Prostate surgery for BPH and urinary retention is regarded as a low risk procedure. In my opinion, although a traditional Trans Urethral Resection of the Prostate (TURP) is a safe procedure, it is not as safe as Green Light Laser Vaporization of the Prostate. Using the new Green Light Laser XPS system, I can successfully treat patients with very large prostates traditionally thought only amenable to TURP or Open Prostatectomy. Green Light Laser surgery is safer than TURP in many respects. There is certainly less bleeding, typically no need for overnight hospitalization, no risk for dangerous fluid shifts associated with absorption of glycine used in TURP and decreased length of catheterization. I have not performed a TURP in my urology practice in Miami for over two years now. I cannot comment on the details of the surgery or outcome related to Dick Clark, however, I do think there is virtually no role for a TURP surgery in the modern era where alternatives therapies for enlarged prostate and urinary retention such as Green Light Laser XPS exist. “
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Hollywood producer and television legend Dick Clark died of a heart attack a day after having prostate surgery, according to a death certificate obtained by CNN.
Clark died last Wednesday at St. John’s Health Center in Santa Monica, California. The day before his death, he had an operation to relieve “acute urinary retention,” an inability to urinate.
“It’s a very painful condition,” says Dr. Kevin McVary, professor of urology at Northwestern University’s Feinberg School of Medicine in Chicago.
The operation is “exceedingly safe” according to McVary, a spokesman with the American Urological Association.
“The mortality rate is less than one in 1,000. That’s very low risk,” he says.
The death certificate lists acute myocardial infarction and coronary artery disease as the causes of death. In December 2004, Clark suffered what was then described as “a mild stroke,” just months after announcing he had been diagnosed with Type 2 diabetes.
Patients with this kind of health history are usually screened by a doctor to test whether their heart is strong enough to withstand surgery, McVary says.
The surgery, known as transurethral resection of the prostate, is considered lower risk because it doesn’t involve an external incision. Instead, doctors insert a surgical tool through the tip of the penis and into the urethra, and then cut away prostate tissue to unblock the flow of urine.
It’s not known why Clark had a heart attack after this procedure. Surgery can be risky for cardiac patients. Anesthesia, for example, can be difficult on the heart, and so can blood pressure fluctuations that occur during surgery.
“Having surgery is a stressful event,” says Dr. Kenneth Rosenfield, an interventional cardiologist at Massachusetts General Hospital in Boston. “It might have been enough to tip him over.”
Green Light Laser Therapy is a minimally invasive surgical option for enlarged prostate (BPH) that combines the effectiveness of the traditional surgical procedure known as transurethral resection of the prostate (TURP), but with less painful recovery, decreased risk for side effects, less bleeding and shorter catheterizations. Miami urologists David Robbins, MD and Amery Wirtshafter, MD routinely perform Green Light Laser procedures.
Green Light Laser therapy to treat enlarged prostate tissue results in a wide open prostate channel for improved urine flow and a quicker return to normal life activities free from bothersome BPH symptoms.
Green Light Laser surgery is typicall performed in an outpatient setting; meaning patients return home within hours of the procedure. After Green Light Laser surgery patients can typically return to normal non-strenuous activities within days. The Green Light Laser system is able to deliver the ultimate treatment for enlarged prostate (BPH) with freedom from bothersome urinary symptoms.
Miami urologists Dr. David Robbins and Dr. Amery Wirtshafter have extensive experience with Green Light Laser surgery for BPH or enlarged prostate and have been providing this service to patients in the Miami region and surrounding areas since Green Light Laser surgery was first introduced.
Greenlight Laser XPS
Miami urologists David Robbins, MD and Amery Wirtshafter, MD are now among a select group of urological surgeons who now offer therapy with the new and improved Green Light Laser XPS sytem which provides improved energy delivery and increased ability to treat patients with very enlarged prostates previously thought not ammenable to minimally invasive surgery.
Click here to watch a video of Dr. Robbins performing Greenlight laser vaporization surgery for BPH (enlarged prostate)
Miami urologists David Robbins, MD and Amery Wirthshafter MD additionally provide a broad spectrum of urological services including treatment for prostate cancer via da Vinci robotic assisted surgery and cryotherapy, treatment for ED including penile implant procedures, treatment of kidney cancer, bladder cancer, testis cancer, management and treatment of female voiding dysfunction and incontinence, vasectomy services and much more.
“I would like to share this patient testimonial written by my patient’s wife who underwent Green Light Laser vaporization of the prostate for enlarged prostate and holmium laser lithotripsy for bladder stones.” David Robbins, MD
Dear Dr. Robbins – I just wanted to take a moment to thank you for such a positive experience this past week when my husband had surgery to remove his bladder stones. We dreaded the whole thing and had postponed the inevitable long past the time when he should have dealt with it. Had we known that you and your staff would make the experience so stress-free, we would have scheduled his surgery sooner. He was up and around in no time and is feeling so much better now. We really appreciate the care and attention you showed and just wanted to make sure you knew how much that meant to us. You can be certain that we will recommend you highly in the future. Thank you!
“I get many questions from patients about saw palmetto and its efficacy for the treatment of BPH or enlarged prostate. Here is an interesting article discussing a head to head trial of saw palmetto versus placebo for symptoms of enlarged prostate.” D.R.
Saw palmetto no better than placebo for prostate problems
By Anne Harding, Health.com updated 6:34 PM EST, Tue September 27, 2011
In clinical trials, saw palmetto has consistently failed to outperform placebo. STORY HIGHLIGHTS Clinical trial finds herbal extract no better than sugar pills for enlarged prostate Saw palmetto has long been marketed as a remedy for symptoms Doctor: “I wouldn’t object, given the no side effects, if men wanted to try it” (Health.com) — The millions of middle-aged men who take saw-palmetto supplements to cope with the symptoms of an enlarged prostate might as well be popping sugar pills. That’s the conclusion of a new clinical trial, published this week in the Journal of the American Medical Association, that found that the herbal extract is no better than placebo at reducing bathroom trips or otherwise improving the urinary-tract symptoms associated with prostate enlargement. “There’s probably no real benefit,” says Simon J. Hall, M.D., the chairman of the urology department at the Mount Sinai School of Medicine, in New York City, who wasn’t involved in the new research. “Ultimately, the way I would look at it is: Is it worth spending $20 or $30 a month to take something that is probably not going to do anything?” Health.com: Must-know facts about male incontinence Nearly all men experience some prostate-gland growth as they age. Most have no obvious symptoms, but because the prostate surrounds the urethra, this otherwise harmless enlargement (known as benign prostatic hyperplasia) sometimes causes symptoms such as dribbling after urination, a weak urine stream, and the frequent need to wake up at night to urinate. Saw palmetto has long been marketed as a remedy for these symptoms, but in clinical trials it has consistently failed to outperform placebo. A 2009 review of 30 randomized controlled trials — including a rigorous 2006 study published in the New England Journal of Medicine — concluded that the herbal extract was no more effective than placebo. In the new study, the largest of its kind to date, the researchers randomly assigned 369 U.S. and Canadian men with prostate-related symptoms to take saw-palmetto capsules or an identical placebo. After 18 months, the men taking saw palmetto were doing no better than those on placebo, even though the dosage of saw palmetto was increased twice during the study, to 960 milligrams — three times the typical daily dose. Health.com: Bladder training tips to reduce bathroom trips Neither saw palmetto nor placebo made a substantial dent in the men’s symptoms. At the beginning of the study, the average severity of the men’s symptoms measured about 14.5 on a 35-point scale commonly used by urologists; by the end, the average severity had declined by three points in the placebo group and just two points in the saw palmetto group. Lead author Michael J. Barry, M.D., a primary care physician at Massachusetts General Hospital, in Boston, points out that between 40% and 45% of the men in both groups saw a “perceptible improvement” in their symptoms, however. That improvement can be chalked up only to the placebo effect, not to any active ingredients in the saw-palmetto extract. But that doesn’t necessarily mean that men shouldn’t take saw palmetto, Barry says. “We can’t show, on the one hand, that it’s better than placebo, but some men do have an improvement in their symptoms, and there seem to be virtually no side effects,” he says. “I wouldn’t object, given the no side effects, if men wanted to try it.” Health.com: 12 myths and facts about incontinence Hall says he doesn’t discourage his patients from taking saw palmetto if the placebo effect appears to be working. “Certainly I’ve had patients tell me…’I’m taking saw palmetto and it’s great,’ and I tell them to keep taking it,” he says. Saw palmetto, with just under $19 million in sales, was the second bestselling herbal supplement in the United States in 2010 (behind cranberry), according to the SymphonyIRI Group, a Chicago-based market-research firm. Barry and his colleagues used a proprietary brand of saw palmetto manufactured in Germany. Since other studies using different brands have had similarly disappointing results, it’s unlikely that one brand is more effective than another, he says. Health.com: Natural remedies for incontinence The study was funded and partially overseen by the National Institutes of Health, although the supplement manufacturer provided all of the saw palmetto and placebo capsules. Other treatment options for prostate-enlargement symptoms include prescription drugs and surgery. In most cases, Hall says, treatment is actually not necessary unless there’s a true medical problem — if a man is not able to completely empty his bladder, for example, or if he experiences recurrent bladder infections. Copyright Health Magazine 2011