General squeamishness about any medical poking around the nether regions aside, it's a treatment you'd expect men with enlarged prostates to be lining up for.

The new procedure, known as photoselective vapourization of the prostate, or PVP, uses a laser to remove non-cancerous tissue, eliminating the need for surgery. That means no bleeding or blood transfusions.

Best of all from a patient perspective, it allows men to go home the same day because it's far less painful. Instead of a two-day hospital stay and morphine, all they need is regular Tylenol.

The laser technique even seems to be better for that quintessential of male concerns, preserving an erection.

From the government's perspective, fewer days in hospital frees up beds and saves money.

What's not to like?

"Rather than cutting it out in chunks, all you're doing is basically turning it into smoke," explains Dr. Paul Whelan, who is heading a study on the procedure at St. Joseph's Healthcare in Hamilton.

"You just vapourize it and at the end it looks like the other surgery, except that there's no bleeding and the fellows heal up faster," the urologist says.

"The way I explain it to patients is that it's like an orange where all you're doing is taking the fruit of the orange out."

St. Joe's is joining Scarborough Hospital and the Trillium Health Centre in Mississauga in testing the treatment.

Launched in May, the study will track the outcomes of men undergoing PVP and the more traditional surgery over two years.

About 90 of the target goal of 160 men have signed up so far and Dr. Whelan says initial results for about 30 in Hamilton are "excellent."

Patients receive a general anaesthetic and surgery is conducted via the urethra with a scope. It takes about an hour.

"It's a kinder, gentler approach of doing the procedure and yet getting the same outcome of what we call the gold-standard procedure (of surgery)," he says.

"The patient can go home the same day and they just have a catheter overnight, rather than the two to three days."

If the study does confirm the benefits of laser treatment, its potential application is broad. Enlargement of the prostate affects more than half of all men over 60, a number that rises to 80 per cent by age 80.

Dr. Whelan says the reasons why the prostate enlarges as men age aren't fully understood, although it has something to do with testosterone levels.

But he said the symptoms can be profound. As the prostate enlarges, it squeezes the urethra, making it more difficult to pee. Men also feel like they have to go to the bathroom all the time.

"It's quite disruptive. When you talk to the guys, the getting up at night disrupts their sleep patterns and they end up exhausted in the morning, they just can't function," Dr. Whelan says.

"Or else they have to jump up out of a meeting or pull the car to the side of the road to go because it's an emergency," he says.

"When you go, it's a poor, dribbly stream, it's weak. You pee on your shoes, you hold up the lineup at the football game so everybody's mad at you. It's a lifestyle issue."

Besides being less invasive than surgery, laser treatment's other major potential benefit is its impact on the bottom line.

Dr. Whelan says each machine costs $130,000 and the procedure $700 per patient.

But if used across Ontario, the treatment could save about 8,000 hospital bed days per year.

If patients who presently choose medication over surgery also opt for the procedure, it could save $30 million per year.

The latter alone in one year could allow the Ministry of Health to buy a laser machine for every hospital in Ontario, says Dr. Whelan, who likes the approach being taken by the province.

"This is a new program for the ministry, to actually evaluate technologies before they're introduced into the health-care system," he says.

"I'd have to applaud them, because then you really know, within our system, is this a good thing or not?

"If it's a good thing, you say, OK, then let's put our resources behind it, and not just introduce it because one of the physicians thought it was a novel idea."

Participants are still being accepted. Call Rebecca at 905-522-1155, Ext. 35876 .