As I understand it, he is correct. There was a post earlier from  
a marketing specialist who suggested that Laserscope were
promoting their product in the wrong way as it is simply a new
tool to do an old job, not a completely new procedure. There is
natural resistance to something totally new. I think he is right
from what I've heard. The techniques are similar, the tools and
results very different.

Derry

David:

I would not want to be anyone's first or even fifth case!

Just my opinion. It stands to reason that a surgeon gets better with
practice. Even with PVP, it would seem some minimal practice/experience
would be advisable.

Mel

The fact that Laserscope requires 10 PVP procedures to have been completed
prior to a name being posted on their website suggests the manufacturers of
the equipment think that's the number required to become really proficient.

dr. laub in s barbara

David,

When it comes to doctors working on our bodies, only the very best seems to
acceptable? But how are we to measure who is the best or has the most
experience?
If you are comfortable with your euro, in my humble opinion, this is good
enough. Chances are, that the guy who does it for the first time, will try
harder than the guy doing three PVP's a day. We have had a post about a
surgeon who scheduled an operation and went out of town. Another case, the
surgeon did not proceed with the surgery because there was not enough time
to complete a big prostate. The patient was already under sedation.
I would make sure that your Dr will actually do the operation and find out
how much time he has allocated.

Good luck

Fred Henzi

There is not a black and white answer to your question.  If you have
relatively small prostate and there are no complications a Uro with minimum
experience will probably not have any problems.  That said, I must tell you
that the first Uro I went to had been doing the procedure for two years and
wrote a book on the PVP procedure.  He aborted the operation because my
prostate was bigger then he expected and was bleeding too much.  I traveled
from Virginia to Florida where a much more experienced doctor (Dr. Lyn) did
the procedure with 100% success.

I am reminded of a conversation where I overheard a salesman recommending
which motorcycle helmet a customer should buy. He asked do you have a $20
head or do you have $250 head?
To me it was well worth the expense and trouble to find the most experienced
doctor I could.

Dave

P.S.  I was very tempted to lean over to that salesman a say "He obviously
has a $20 head or he would not be riding a motorcycle."  No flames please, I
have enjoyed riding a motorcycle with and without a helmet.

Dr. Nseyo who teaches urology and the PVP procedure at the Veterans hospital
in Richmond Virginia was the first doctor who attempted the operation.  This
guy sells a book on the Internet for student doctors to learn how to perform
PVP.  I thought that made him a world class expert and maybe he is.  I was
conscious during the all of the first operation.  I became concerned when a
troubled sounding voice from the small crowd of people between my legs said.
"It's not long enough." I wondered what they were talking about, my penis or
the fiber cable!?!?
Dr. Nseyo appeared near my head and explained that my prostate is much
bigger then they expected and I bleed profusely every time it's touched.
This means that the operation would take more time then they have scheduled
for me and they have others waiting to have the operation done this same
day.  He went on to suggest that I consider having an open prostectomy
where the would cut me open from navel to pelvis, reach in and peal it open
like the skin of an orange.  He would then remove the tissue from within the
prostate, sew the outer skin back together. I would be fitted with a tap
under my navel to from which to urinate until the prostate skin healed and
then come back to have it reattached.

Even under the influence of the happy drugs I was on, this seemed like a bad
idea to me.  I told him to let me off the table, I will continue to treat it
with drugs rather then have such an invasive operation.  He then suggested
that I take Proscar for a period of time to shrink the gland, come back and
he will "stage" the operation doing a little at a time and sending me home
with a catheter still in me.

When I got home I contacted Dr. Lin in Florida who I learned about from this
news group.  I had Dr. Lin and Dr. Nsyeo talk to each other on the phone so
Dr. Lin could understand the problem.

Dr Lin had me have a CAT scan done of the area and the results sent to him.
He then called me back and told me that he thinks he can do the surgery.  We
scheduled it for the end of July 2003.

When I first visited Dr. Lin he did a digital examination and when I turned
around I saw that he was all smiles.  He was now confident that the
operation would be a success and he would not need to stage me.   The next
day I went in for the surgery.  I was conscious for the early parts of the
operation.  I could see clouds of blood bellowing out when the prostate was
hit by the laser.  I watched as Lin slowed and attempted to stop the flow of
blood.  It seemed that the operation speeded up, I could see large chunks of
tissue being removed and blood was obscuring the view most of the time.  I
could see that the LASER probe was being pumped back and forth.  Most of
the time it was obscured from view by blood but some times it would poke
thru and be visible. I lost consciousness.

When I recovered consciousness Dr. Lin came to me and told me that the
operation was a complete success he cleaned almost all of the tissue in the
gland.  He was beaming with pride.  He explained to me that he now
understands why Nseyo had a problem with me. He explained that inexperienced
doctors depend on being able to see what they are doing.  In my case,
because I bleed so much, it would have taken forever because he would need
to cut a little, stop cutting and stop the bleeding, clear the view and
start cutting again.  Because he has so much experience and has done so many
of these operations, he can do it by "feel" and does not need to see what is
going on at all times.

I'm grateful that Dr. Nseyo was man enough to recognize that the operation
was beyond his skill and also grateful that I found Dr. Lin.  Dr. Lin and I
now consider each other as friends.

I had retro-ejaculation for about four months.  That has recently cured it's
self and I'm now operating at 100%.

I'm sorry if I went on for too long but I think that there a lesson to learn
from my story.

Dave