PVP GreenLight Laser Surgery (photovaporisation of the prostate)

PVP GreenLight Laser surgery is an alternative, very safe method of treating the bladder outflow obstruction suffered by men with enlarged prostate glands. While Transurethral Resection of the Prostate (TURP) has been regarded as the gold standard surgical treatment for benign prostatic hyperplasia (BPH) or enlarged prostate, the prospect of this less invasive treatment is very attractive and is now regarded by NICE "at least as good" as the TURP technique.

GreenLight Laser still requires an admission to hospital but can often be performed as a day case, recovery is quicker in the short term and following treatment you can expect to be back at work faster. A catheter (a tube which drains the bladder) is still needed but, can be removed sooner than alternative procedures and can even be removed on the day of surgery in some cases. Patients are advised to avoid straining or heavy lifting for 10 days or so after the surgery and to take life easy.

Who is it suitable for?

GreenLight Laser surgery is suitable for any patient that TURP is indicated, with the exception of men who need laboratory analysis of the prostate tissue that is removed. The latter will be relatively few with the use of the prostate-specific antigen (PSA) tests and other prostate diagnostics that are available.

How does it work?

A laser is used to remove much of the prostate tissue in order to relieve pressure on the urethra. A probe is inserted and under the guidance of the surgeon, the overgrown tissue is vaporised by the laser energy. The laser is precise and very effective at stopping any tissue from bleeding; as a result little or no bladder irrigation is required in the post-operative period.

Side-effects are similar to those of TURP and may include the usual risk of an infection as with any invasive procedure. However, GreenLight Laser ensures that there is much less bleeding than with TURP, and the laser procedure is considered less invasive. Typically this means the hospital stay is shorter and recovery faster. However, similar to TURP patients can feel a burning/stinging sensation for some time after the procedure and this may last for a few weeks following the procedure. Men may pass some blood and occasionally small blood clots up-to a month afterwards, this is normal, and should cease without any need to see a doctor.

The only significant side-effect is almost certainly the loss of normal ejaculation. This is because the contraction that occurs during orgasm may not completely block the entrance to the bladder once some tissue has been removed, and the semen will flow back into the bladder ("retrograde" or "dry" ejaculation) rather than out through the penis. The procedure including risks will be discussed in full with the surgeon prior to any with your doctor or surgeon if you are concerned before your treatment.

Paying for your operation

GreenLight Laser costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment, the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon's fee, the anaesthetist's fee and the hospital charge for your procedure.

The information should not replace advice that your relevant health professional would give you. For more information about this procedure please call BMI Healthcare to arrange an appointment with a healthcare professional on 0808 101 0337.

Information provided by Mr Anthony Riddick, Consultant Urologist at BMI St Edmunds Hospital

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