Greenlight Laser PVP (Photoselective Vaporization of the Prostate)
GreenLightTM Laser PVP
(Photoselective Vaporization of the Prostate) is a procedure used in the treatment of Benign Prostatic Hyperplasia (BPH)
, an enlargement of the prostate gland, resulting in urethral restriction. The prostate is a small gland circling the urethra immediately below the neck of the bladder. It has a vital function in the male reproductive system by secreting a fluid into the urethra during ejaculation.
What is Benign Prostatic Hyperplasia?
BPH is an overgrowth of prostate cells occurring in nearly 50% of men over age 55 and 80-90% of men by age 80. It's believed to be caused by hormonal changes which, although natural, produce an unnatural overgrowth of prostatic cells. No definitive cause has been identified, but it only occurs in older men and a family history of the condition increases the likelihood of developing BPH. As the prostate grows, it begins squeezing the urethra creating uncomfortable and inconvenient urination problems, such as frequent urination, especially at night, a hesitant and intermittent flow, urgency, dribbling, and a feeling that the bladder is not emptied. When the discomfort affects a man's quality of life, he consults a urologist, a medical doctor specializing in urogenital diseases. Once BPH is confirmed, treatment can begin. There is no cure for this disease and, while symptoms of BPH and prostate cancer can be similar, BPH has never been shown to be a precursor or predictor of prostate cancer.
Treatment for BPH
Historically, successful treatment for BPH required an open prostatectomy; a major abdominal surgery requiring a lengthy hospital stay and months of recovery. When instrumentation made it possible to reach the prostate gland by entering the urethra rather than abdominally, a procedure called transurethral resection of the prostate (TURP
) became the preferred treatment. It is considered safe, effective, and efficient. However, doctors and patients wanted even shorter recovery times, quicker results, and fewer long-term side-effects, leading to alternative treatment methods being developed. Over the past two decades procedures to treat BPH have taken advantage of advanced energy sources, such as lasers, microwaves, radio waves, and ultrasound. These new technologies have achieved the goal of being less invasive and provide shorter recovery periods and more immediate results for patients.
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GreenlightTM Laser PVP Treatment
Laser PVP is a recent addition to the minimally-invasive techniques for treating BPH. It's a procedure which uses the technology of high-powered laser light combined with fiber optics to vaporize the overgrowth of prostate cells quickly and accurately. As the surgeon directs the laser at the prostate, the intense pulses of light emitted from the fiber are absorbed by the blood. Within moments the temperature of the blood becomes so great it causes the nearby cells to vaporize. GreenLightTM
is being used as an alternative to transurethral resection of the prostate (TURP
) and has been shown to be its equal in terms of effectiveness in improvement of symptoms. There is growing interest in this technique by patients and practitioners because of its simplicity and efficiency. GreenLightTM
is alone in being able to give patients quick symptom relief, ease and comfort of urinary flow, and minimal short-term side effects. This technique is too new for long-term studies to have been completed, but after five years it has been shown to maintain its level of improvement in urinary flow and comfort, and for giving men the quality of life they deserve.
What is the Procedure?
GreenLightTM Laser PVP
is an out-patient procedure performed by a urologist with special training in the technique. The anesthesia can be general, spinal, or nerve blocking along with sedation. The surgeon inserts a cystoscope (a tube equipped with a light) through the urethra to the prostate gland. A thin fiber is run through the cystoscope and placed in the urethra adjacent to the obstruction. Pulses of light radiate from the end of the fiber as the surgeon directs them towards the areas of overgrowth. The light is easily absorbed by the blood which becomes heated to the point that nearby tissues are vaporized. The doctor continues applying this laser light until the destruction of tissue reduces the restriction on the urethra. As the tissue is being vaporized the heat seals off the blood vessels, resulting in less bleeding than in other treatment options. A temporary catheter is often inserted to allow urine to drain from the bladder. The procedure takes approximately sixty minutes.
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After the Procedure
Patients are observed in a recovery area following the procedure and are typically discharged within a few hours. GreenLightTM
PVP patients will typically have their catheter removed two days after treatment. For some men, particularly those whose symptoms had been severe or had prior damage to their bladder, a longer period of catheterization is required.
Mild discomfort such as slight burning while urinating and small amount of blood in the urine during the first week is to be expected. Frequency and a sudden urge to urinate may occur for a short period of time as the urethra adjusts to changes. However, patients will notice a dramatic improvement in urine flow and relief of symptoms within a day or two of the procedure. Those with multiple health issues may not experience improvement quite as quickly.
Many men find they can return to normal activities by three days after GreenLightTM
PVP. It is recommended that patients refrain from strenuous exercise and heavy lifting or pushing, as well as working with equipment that vibrates for at least two weeks. Such activities aggravate the urogenital area and can cause bleeding. Sexual activity should be avoided for two to three weeks and resumed when the patient is comfortable doing so. Patients may experience retrograde ejaculation or diminished volume, neither of which affects orgasm or sexual pleasure.
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The Many Benefits of GreenlightTM Laser Photoselective Vaporization of the Prostate
- Minimal bleeding
- Only 30% of patients need a post-op catheter
- Discharge on the same day
- Resume normal activities in 2 to 3 days with caution
- Return to vigorous activity level in 4 to 6 weeks
- Complications occur infrequently and are mild if they do
- Post-operative impotence has not been associated with PVP
- Retrograde ejaculation is less likely with PVP
- Erectile Dysfunction is not typical in PVP patients
- Long-term success in improved urine flow
- Fewer symptoms of urinary obstruction
PVP has been enthusiastically acclaimed as a significant breakthrough in laser techniques in precisely vaporizing the overgrowth of prostate cells without damage to surrounding tissues and vessels. It is safe, effective, simple, offers a quick recovery, and a recognized improvement over other minimally-invasive treatment procedures currently available for BPH.
Contact Dr. Samidi to learn more about GreenlightTM Laser PVP and other treatments for Benign Prostatic Hyperplasia.
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