GreenLight Laser Prostate Procedure

GreenLight laser prostatectomy is a safe, effective and efficient treatment to ease urinary symptoms in patients with benign prostatic hyperplasia (BPH), enlargement of the prostate gland. It is a minimally invasive procedure which utilizes a 532nm wavelength laser to remove excess prostate tissue blocking the urethra by vaporization. This laser appears green in colour so this surgery is also called GreenLight laser therapy. The laser with this specific wavelength is chosen as it is selectively absorbed by the red prostate tissue and poorly absorbed by water. The procedure is also known as Photoselective Vaporization of the Prostate (PVP).

Advantages

GreenLight laser prostatectomy has several advantages over other treatment procedures for benign prostatic hyperplasia, including:

• Minimal blood loss. It virtually causes no bleeding as the laser creates a 1-2 mm zone of coagulation necrosis around the area of vaporization. The laser also cauterizes the ruptured blood vessels during the surgery controlling any bleeding.
• Offers immediate symptomatic relief and significant improvement in urine flow after the surgery.
• It is a safer procedure with fewer complications. Recovery is much quicker. In an otherwise healthy patient, it is done as an outpatient procedure and the patient is discharged the same day of the procedure. Only some patients may have to stay overnight in the hospital.
• Long-term symptomatic relief lasting for about five years.
• The procedure is also safe and effective for patients on anticoagulation therapy

Indications

It is common for the prostate gland to become enlarged as a man ages. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to constrict the urethra. This leads to a number of urination and bladder problems such as urinary hesitancy, frequent urination, urinary tract infection and urinary retention. This is referred to as Benign Prostatic Hyperplasia (BPH). BPH is more common in men above 60 years of age.

GreenLight laser prostatectomy is indicated in these patients to remove the excess prostate tissue blocking the urethra to ease the urinary symptoms.

Technique

GreenLight Laser prostatectomy is performed under general or spinal anaesthesia. The laser is delivered through a flexible fibre passed through a cystoscope, a tube like instrument with a light and a camera at one of its ends. The cystoscope along with the flexible fibre is inserted through the urethral opening of the penis. The real time images from the cystoscope are displayed on the monitor in the operating room. The surgeon controls the direction and delivery of the laser energy through the flexible fibre tube, under the guidance of real time imaging. Laser energy is delivered as small bursts, lasting for a few seconds, to vaporise the prostate tissue. Continuous flow of irrigation fluid is maintained to remove the cut prostate tissue, keep the fibre tip cool and to maintain a clear view of the operative area. The cystoscope with the fibre is slowly manipulated through the urethra, removing the obstructing prostate tissue thereby enlarging the space within the urethra and restoring normal urine flow. At the end of the procedure a catheter is placed in the bladder and is usually removed the next day after surgery.

Patients are usually discharged on the same day of the procedure but may be kept overnight and discharged the next day.