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Medical Forum / Diseases and Disorders / Prostate BPH / December 2003LTURP
Laserscope has a great new prostate procedure but they errored in naming it. They should have gone with LTURP. Greenlight PVP, or just, PVP, as they call it is still a very much an unknown in the insurance and the urological community. TURP is a known as it has been the gold standard for 50 years. LTURP would build upon a known procedure name while adding the L(laser) technology. PVP now has 6-8% of the market and continues to grow. But getting to a 50%+ market share would be obtained quicker if they switched to LTURP. I disagree. PVP is so vastly different from a TURP that it should have a different name and a different code. PVP is not a Laser TURP. PVP means photoselective vaporization of the prostate. The laser light is tuned to the correct wavelength to vaporize prostate tissue, i.e. photoselective on just prostate tissue. It is the Photoselective nature of the laser for prostate tissue that makes PVP special and unique and quite different from a TURP rotary blade or even a laser TURP. Recently Medicare recognized the major differences between the two procedures by giving the PVP a separate code. PVP is Medicare approved procedure so now insurance companies will get on the badwagon for a simple reason. PVP is less costly overall than a TURP when you add up all the costs such as hospital stay, etc.. Within a few years, TURPs will no longer be done in this country as well as no longer be taught in med schools. I believe that this will happen before 2006. Patrick > Laserscope has a great new prostate procedure but they errored in naming it. > They should have gone with LTURP. Greenlight PVP, or just, PVP, as they call [quoted text clipped - 4 lines] > getting to a 50%+ market share would be obtained quicker if they switched to > LTURP. A doctor in NJ (misleadingly) refers to PVP, which he does, as LaserTurp. Jesse > I disagree. PVP is so vastly different from a TURP that it should have a > different name and a different code. PVP is not a Laser TURP. PVP means [quoted text clipped - 29 lines] > to > > LTURP. >I disagree. PVP is so vastly different from a TURP that it should have a >different name and a different code. PVP is not a Laser TURP. PVP means [quoted text clipped - 17 lines] > >Patrick I think you are probably right... if only it would happen in Connecticut before then! I could get PVP done in Providence RI or NYC, but I don't think insurance will pay for it. According to a note posted some time ago in this group, the out of pocket cost for a self pay patient at the Providence shop is about $14k - I can't afford it. However, I have an appointment to see my uro next week to follow up on an ER visit I made last night for 'urinary retention' for which the remedy is a catheter. It was my first episode with this phenominon - outside of a similar episode I had about 5 years ago after having arthroscopic knee surgery unrelated to the enlarged prostate. They said that episode was connected to the anesthetics. Could be, I only with I had some warning :^} But this episode was a nightmare. Two things: 1- I drank some coffee after 6pm, and 2- I was on the highway stuck in a traffic jam, I couldn't get to a bathroom until I'd had the urge for over an hour. Ouch! Anyway, I'm going to ask him about PVP, and how to find out if insurance will cover an out of state procedure. I am a governmental employee, BC/BS, one of the big insurance carriers. Which has both its advantages and disadvantages. I'll post back and let you know. -John- I'm hoping to get a PVP fom Mayo Clinic in Minnesota in two weeks. Their cost estimating section indicated PVP $7,700 - $9,100. TURP $15,000 - $18,500. Dennis > >I disagree. PVP is so vastly different from a TURP that it should have a > >different name and a different code. PVP is not a Laser TURP. PVP means [quoted text clipped - 41 lines] > > I'll post back and let you know. -John- Attention: dohlund@comcast.net RE Dennis' cost estimate of PVP at Mayo Clinic is $7,700 to $9,100 -- Turp $15,000 to $18,500. It is wise to get price estimates before any operation, also get estimate of how little Medicare pays. It would be well to determine directly with your personal or company insurance carrier what they are willing to pay. My doctor - a real "pro" with ten years experience with laser surgery before he was trained on PVP charged $2148. The anesthesia was $616, the hospital room for one night was $840. for double occupancy. Total Medicare payment is still not clear. So -- those of your that live near Seattle and need PVP -- contact me off line if you want details. Regards, John Kutina > Two > things: 1- I drank some coffee after 6pm, and 2- I was on the highway > stuck in a traffic jam, I couldn't get to a bathroom until I'd had the > urge for over an hour. Ouch! A practical suggestion: I got one of those plastic hospital urine containers from Wal-mart for about $2.50 that I now carry under the front seat of the car for these types of "emergencies". Works like a charm and worth ten times the price when you need it :-)  SignatureJack > > Two > > things: 1- I drank some coffee after 6pm, and 2- I was on the highway [quoted text clipped - 5 lines] > front seat of the car for these types of "emergencies". Works like a > charm and worth ten times the price when you need it :-) I used to carry one of those in my car, but now I have something much better, which I carry everywhere. It is called a 'uribag' (see www.uribag.com ). It is a rubber bag which folds up discretely into a plastic cylinder with a secure lid attached to it. I rarely use it, but when I do, it is a (social) life saver. Example, I was in a mini-bus with a group of colleagues on the way to an airport, when I began to feel that sudden urge to pee, and knowing my prostate-damaged bladder, knew that by the time we got to the airport and I searched for a toilet, I would have wet myself completely. I was able to sneak the uribag out of my bag, and under my coat. Under cover of my coat and bag I urinated safely to my huge relief, with none of the people around me any wiser. Highly recommended. Gary Oh, so YOU wee the guy I saw urinating in the bus! <g> Mel > > > Two > > > things: 1- I drank some coffee after 6pm, and 2- I was on the highway [quoted text clipped - 22 lines] > Highly recommended. > Gary Uribag in US? Found using Google but all distributors seem to be overseas. Looks like a good and convenient design. >However, I have an appointment to see my uro next week to follow up on >an ER visit I made last night for 'urinary retention' for which the [quoted text clipped - 13 lines] > >I'll post back and let you know. -John- Well, it's been about 4 weeks since that urinary retention episode. I went to my uro (do they all seem about 1/2 - if that - our age?). I like him a lot. Since I'm on Avodart, my PSA should be about 1/2 what it would normally show - he says double the number - he's going to do a biopsy to rule out The Big C. My PSA is 4, but double that is 8, and that is worrisome. Still, I'm not worried. That PSA was done about the time I started Avodart, so should be good. Anyway, gonna have the biopsy, no news is good news. He started making noises about getting aggressive, there are TURP and microwave options, among others, he says. I asked him about PVP, he knew all about it, considered getting set up to do it in his practice (of maybe 4 uros practicing together) but they decided it was too invasive for an office practice. And TUPR is okay for an office visit? I asked. Oh, no! You'd be hospitalized for that, but the nature of PVP is that it lends itself to an office visit. I told him to put me on the list if/when it gets set up. I want to encourage him. There are no uros offering PVP in Connecticut, I think I mentioned this. I doubt my insurance would cover the trip to Providence, but I'm going to ask him for a referral anyway, and call the insurance company and see what they say. Wednesday, I get the biopsy. An office visit, sounds quite invasive to me, speaking of invasive. He gave me a home enema project, do it an hour before coming to the office, where he'll put sharp instruments up my ... nether orifices. 'Expect blood in the urine for a few days, and in the ejaculate for 6 or 7 weeks. Nothing to be concerned about.' Of course, easier concept for him than for me. I'll report back his reaction when I push for the PVP, he seemed open to it a few weeks ago, almost like he was sitting on the fence. I'd like to convince him. I told him I'd wait until he got if fired up. Still, I'd rather not be his 1st... -John- John, If you are Federal government, FEHB, and have standard option, you will have no problem with out of state. I live in NJ, and went to NY for PVP with Dr Te. They will not pay your travel expense, but the medical part was covered for me. Al >>However, I have an appointment to see my uro next week to follow up on >>an ER visit I made last night for 'urinary retention' for which the [quoted text clipped - 47 lines] > like to convince him. I told him I'd wait until he got if fired up. > Still, I'd rather not be his 1st... -John- |
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