Dr. Steven Gange, of Summit Urology – Holladay, has recently had his practice designated the first-ever Urolift Center of Excellence in the world. To appreciate the importance of this honor, it is necessary to understand the ground-breaking importance of the Urolift procedure.
If you are a man over the age of 50, chances are you have begun to notice changes in urination related to Benign Prostatic Hyperplasia (BPH), commonly referred to as an enlarged prostate. Although the prostate is principally a sexual organ (producing seminal fluid), it also encircles the tube through which men urinate (the urethra).
As men age the prostate both enlarges and tightens, ultimately restricting the flow of urine exiting the bladder, thereby creating numerous annoying voiding symptoms (like slow flow, urgency, dribbling, and nighttime trips to the bathroom). This condition affects most men: at least one-third of men will undergo some form of treatment for BPH in their lifetime.
In the past, BPH was most commonly treated with a surgery called TURP (transurethral resection of the prostate), sometimes referred to by men as a “roto-rooter.” Developed in the 1930’s, (with minor modifications since then) this procedure involves full anesthesia, a temporary catheter tube to help control bleeding, possible hospital stay, significant recovery time, and some potentially bothersome sexual side effects – 70% percent of men lose the ability to ejaculate, and 10% develop erectile dysfunction. With no good alternatives, TURP was the #1 most frequently performed surgery in the US throughout the 1960-70s. In the 1980-90s, BPH medications were developed, and TURP numbers began to decline; nevertheless medications are much less effective, and carry their own side-effect risks, so men continue to need procedural intervention for BPH. Laser-TURP procedures cause less bleeding and have gained in popularity, though have in no way eliminated side effects of TURP. After the abject failure of balloon dilation and stenting the prostate in the late 1990s, several minimally-invasive heat-based procedures were developed in the early 2000’s designed to be conducted in an office setting with less than full anesthesia; these are now waning in popularity because of problems with patient tolerability and a lack of durable effect.
Finally, a BPH procedure is available that is truly minimally invasive, without cutting or heating, very tolerable in an office setting under local anesthesia, without any sexual side effects and with much greater durability than any in-office procedure that came before it, and it is called UroLift (NeoTract, Pleasanton, CA). And Granger’s own Summit Urology Group’s Dr. Steven Gange has been instrumental in its development.
Invented in 2004 by a pair of Ph.D. biomedical engineers, the UroLift procedure is elegant in its simplicity. Rather than superheating or cutting tissue or otherwise changing the natural architecture of the prostate, the UroLift implant lifts (or more accurately pushes) the obstructing prostate away from the urethra, opening the narrowing and facilitating a return to normal urination. The procedure takes advantage of the natural urethral access and leaves no scars. 4-6 implants are applied in this 10-minute office procedure, and no catheter is typically required. Clinical trials for UroLift began in Australia in 2005 and later in Europe, in both locations performed exclusively in the operating room under full anesthesia. As news of the early successes reached the US, Dr. Steven Gange and his urologist partner Dr. Stephen Richardson (both involved in conducting clinical trials with Jean Brown Research) enthusiastically worked to become a part of the US FDA trial. The randomized LIFT trial as it was known took UroLift implantation a step further: these UroLift procedures would be conducted under local anesthesia. Jean Brown was selected as a treatment site for the LIFT trial, and on 3/18/2011 Dr. Gange (as Principal Investigator) performed not only the first UroLift in North America but the first UroLift in the world under local anesthesia. With Dr. Richardson as sub-Investigator, the two enrolled more men in the trial than anyone else in the US and Canada, and by so doing helped to reinforce the effectiveness seen in the International trials, but also demonstrating the unique level of tolerability of UroLift when performed under local anesthesia. Drs. Gange and Richardson have gone on to conduct two additional UroLift trials, and have been recognized for their efforts with co-authorship of many of the pivotal UroLift papers in the urological literature. Dr. Gange has been asked to present the UroLift research findings at several national urology meetings.
Upon successful completion of the LIFT trial, UroLift received FDA clearance in 2013. About a year later, Dr. Richardson, who for 20 years had himself been suffering from the symptoms of BPH but was unwilling to subject himself to the side effects of medications or the rigors of the available procedure options, asked Dr. Gange to perform his UroLift. His experience with the procedure was exactly as he expected – the six-minute procedure done in-office and under the same local anesthesia he had witnessed in his clinical trial subjects, caused only mild discomfort. No catheter was required, and he worked ten hours the next day without any issues whatsoever. His life has effectively been transformed and for the first time in two decades he now sleeps through the night. As a researcher, highly experienced clinical urologist, and now himself a UroLift patient, he has become a vocal advocate, and he now speaks regularly to BPH patients and patient groups across the country.
Spring boarding from the clinical trials experience Dr. Gange has further refined his anesthetic protocol to maximize tolerability while minimizing risks to patient safety. He has treated more men with in-office UroLift under local anesthesia than anyone in the world, including other physicians, corporate leaders, professional athletes, and men from across the US and even from several foreign countries. As his Summit Urology Group Highland Office team has gained expertise, NeoTract (the manufacturer of UroLift) has defined theirs as a Premier Patient Experience, and the company regularly sends urologists and their teams to Salt Lake City to observe cases. Further, as a consultant and inaugural Faculty Member for NeoTract, Dr. Gange has traveled extensively across North America teaching and proctoring urologists who are learning UroLift. As a result of his large number of procedures with consistently high-quality patient outcomes and his devotion to teaching and training others, Dr. Gange was awarded the first-ever UroLift Center of Excellence designee on November 1, 2016.
Approximately 1,000 US urologists are now trained to perform UroLift, including most of Dr. Gange’s Summit Urology partners. Currently, Summit Urology is the only place in the Salt Lake Valley that regularly performs this procedure. If you are bothered by BPH or the side-effects of medications used for it, look to Summit Urology Group for truly expert and state-of-the-art BPH care.