Green Light Laser Surgery (For BPH)
Introduction To Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate (TURP) was formerly the main operation for relieving symptoms due to benign prostate enlargement. However recently other minimally invasive techniques have been developed, such as GreenLight Laser treatment. The GreenLight PVP system uses a high powered KTP-YAG laser to core out the prostate by vaporising the centre of the gland, leaving a wide channel and thereby relieving your urinary symptoms.
Main Advantages Of Green Light Laser Surgery
- The operation can be carried out as a day case procedure at Baddow Hospital.
- The catheter tube is removed within 24 hours of surgery and some patients may not require a catheter at all.
- Due to red absorption of the laser, bleeding is practically zero.
- Long term results appear to be favourable and seem similar to those of a routine TURP.
Before Your Prostate Surgery
Approximately one week prior to admission, you will be asked to attend the pre-assessment clinic. Pre-anaesthetic checks include: blood tests, urine tests, heart tracing (ECG) and possibly a chest X-Ray. Both a doctor and a nurse will carry out the relevant documentation, giving you the opportunity to ask questions. As this is a relatively new procedure, you will be asked to fill out a symptom/health questionnaire. This will form part of our on going audit, and enable us to assess the effectiveness of this treatment over time.
You will also have an ultrasound examination of your prostate to assess its size. At pre-assessment, you will be required to bring a list of your current medications and provide a urine specimen. Aspirin may be continued. However, if you take Warfarin, the dose may have to be modified prior to admission.
Possible Side Effects of Laser Prostate Treatment
Before you sign the consent form, please ensure you understand what the surgery entails and possible side-effects:
- Bleeding – unlike TURP, this is rare. Transfusion is not necessary with this procedure.
- Effects on your sex life – 25% of men experience retrograde (“dry”) ejaculation; TURP remains around 90%. If this occurs, it’s unlikely you could father children, but you can’t rely on this as a method of contraception. Some men report a change in sensation of orgasm.
- Impaired erection – Unreported with GreenLight PVP, but remains a theoretical risk.
- Urinary control – 7% of men experience mild discomfort of the urethra (water-pipe) immediately after the operation. This usually lasts a few hours while you’re in the recovery room. Inability to pass urine after the operation can occur in up to 5% of patients. This may require a short period of further catheterisation before you have to re-attend for removal of the catheter as an outpatient.
- Erectile Disfunction – This is unreported with Green Light Laser, but it remains a risk.
Additional Information About Prostate Surgery
The operation takes about 45 minutes. When you come out of the anaesthesia you may have a catheter in place but unlike TURP procedure this will be for a short while.
After Your Laser Prostate Surgery
If a catheter was required it will be removed and you should be able to go home on the same day. On your discharge you may be sent home with medication.
The catheter is removed a few hours after surgery and you can go home the same day. If you run into problems at home, you can telephone for advice. You will be sent home with any medication you need and a letter for your GP.
- Strenuous activity (e.g. digging) should be avoided for 2 weeks following your operation.
- Driving can be resumed after one week (some car insurances are not valid during the recovery period after an operation).
- Sports such as golf or cycling may be resumed after two weeks or when you feel fit.
- Avoid becoming constipated as straining may lead to bleeding from your prostate cavity.
- Sexual activity may be resumed as you feel fit. If you do ejaculate, there may be discolouration of the semen for some weeks. This is normal and soon settles.
- Return to work when you feel fit (normally between 2-7 days).
- Follow-up – You will be given a follow up appointment date on discharge.