Greenlight Laser Photoselective Vaporization of the Prostate (PVP)

The Greenlight laser photoselective vaporization of the prostate (PVP) is a minimally invasive surgical procedure used to treat benign prostatic hyperplasia (BPH), also known as enlarged prostate.

Overview

This procedure uses a high-powered laser to vaporize excess prostate tissue that is obstructing urine flow. The Greenlight laser emits a specific wavelength of light that is absorbed by hemoglobin in the blood, allowing for precise removal of prostate tissue while minimizing damage to surrounding tissues.

Indications

The Greenlight laser PVP procedure is typically indicated for men with:

• Benign prostatic hyperplasia (BPH) with moderate to severe symptoms
• Enlarged prostate causing urinary obstruction
• Failed medical therapy or inability to tolerate medications
• High-risk patients for traditional surgical procedures, such as those with bleeding disorders or on anticoagulant therapy

Procedure

The Greenlight laser PVP procedure is usually performed under general anesthesia or spinal anesthesia. The procedure involves:

1. Cystoscopy: A flexible or rigid cystoscope is inserted through the urethra to visualize the prostate and bladder.
2. Laser vaporization: The Greenlight laser fiber is inserted through the cystoscope and used to vaporize excess prostate tissue.
3. Coagulation: The laser also coagulates blood vessels, reducing bleeding and promoting hemostasis.

Advantages

The Greenlight laser PVP procedure offers several advantages, including:

• Minimally invasive: Reduces risk of complications and promotes faster recovery
• Less bleeding: The laser's coagulative properties minimize bleeding and reduce the need for blood transfusions
• Shorter hospital stay: Typically an outpatient procedure or requires only a short hospital stay
• Rapid symptom improvement: Most men experience significant improvement in urinary symptoms within a few days to weeks after the procedure

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with Greenlight laser PVP, including:

• Bleeding or hemorrhage
• Urinary retention or incontinence
• Urinary tract infection (UTI)
• Bladder neck contracture or stricture
• Erectile dysfunction or retrograde ejaculation

Postoperative Care

After the procedure, patients typically require:

• Urinary catheterization for a short period to ensure adequate urine drainage
• Pain management with oral medications
• Antibiotics to prevent infection
• Follow-up appointments to monitor progress and remove the catheter

Outcomes

Studies have shown that Greenlight laser PVP is an effective treatment for BPH, with:

• Significant improvement in urinary symptoms and quality of life
• High success rates, with most men experiencing long-term symptom relief
• Low complication rates compared to traditional surgical procedures