Green Laser Prostatectomy

The prostate gland is an organ found only in men. It is located at the outlet of the urinary bladder and surrounds part of the urethra, the tube through which urine passes. The function of the prostate is to help control the flow of urine and to produce seminal fluid. As men age, the prostate commonly grows larger, a condition known as benign prostate hypertrophy or BPH, not to be confused with prostate cancer. An enlarged prostate can constrict the urethra making it difficult to void urine. One method of treating BPH is by green laser prostatectomy, also called photosensitive vaporization of the prostate (PVP).

Symptoms

• Green laser prostatectomy is a technique that uses green laser light energy to vaporize excess prostate tissue quickly and precisely. A green laser prostatectomy is done to relieve the symptoms of an enlarged prostate. Symptoms include frequent urination, urinating more at night, stopping and starting, weak urine flow, the sensation that the bladder is not empty, or in extreme cases an inability to pass urine at all.

Risks

• Green laser prostatectomy surgery has fewer complications than invasive procedures, methods that involve cutting through the skin to reach the prostate. These risks can involve difficulty in urinating immediately following the procedure, temporarily requiring a urinary catheter to drain urine from the bladder, urinary tract infections, scar formation that may require further treatment, retrograde ejaculation, a condition in which semen flows into the bladder, and erectile difficulty. Fortunately, these complications are rare.

Preparation

• Starting ten days before the procedure, you will be required to stop or reduce any blood thinning medications, such as aspirin, ibuprofen, vitamin A, naproxen, Coumadin, or warfarin, in order to reduce bleeding. An electrocardiogram (EKG), chest X-ray, and blood tests will also be done about ten days before your surgery. If your doctor decides on a general anesthesia, you will be told not to eat or drink anything after midnight on the day of your surgery. Your doctor may also prescribe an antibiotic and pain medication.

The Procedure

• Green laser prostatectomy is done in the hospital, typically as an outpatient procedure. Although occasionally an overnight stay is required, it is not unusual to be out of the hospital in a few hours. An anesthetist will administer a general anesthetic or a spinal block. Your surgeon will insert the laser optic device through the penis to reach the prostate. Using the green light laser, the surgeon will vaporize the excess prostate tissue causing the problem. The surgery usually takes less than an hour.

Results

• Improvement in urine flow is usually noticeable immediately. Patients who have been followed for five years report continuing good results, but in some cases further treatment was necessary. Recovery time is about two weeks, with most patients resuming strenuous activity within about four to six weeks. If possible, you should arrange for two weeks off from work.