Green Light Laser Surgery

What is green light laser prostatectomy?

Green light laser prostatectomy is a safe and effective treatment to remove the prostate gland and ease urinary symptoms in patients with benign prostatic hyperplasia (BPH), which is the enlargement of the prostate gland. It is a minimally invasive procedure that utilises a 532nm wavelength laser to vaporise and remove excess prostate tissue blocking the urethra. The laser with this specific wavelength is chosen as it is selectively absorbed by the hemaglobin in red blood cells and not absorbed by water, so it provides excellent hemostasis. The procedure is also known as photo selective vaporisation of the prostate (PVP).

How is green light laser prostatectomy performed?

Green light laser prostatectomy is performed under general or spinal anaesthesia. 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. Real-time images from the cystoscope are displayed on the monitor in the operating room, which helps your surgeon to control the direction and delivery of the laser energy. The cystoscope along with the flexible fibre is inserted through the urethral opening of the penis, and slowly manipulated through the urethra, removing the obstructing prostate tissue,enlarging the space within the urethra and restoring normal urine flow. Laser energy is delivered to vaporise the prostate tissue.

Continuous flow of irrigation fluid is maintained to remove the vaporised prostate tissue, keep the fibre tip cool and to maintain a clear view of the operative area. At the end of the procedure a catheter is placed in the bladder and is usually removed the next day after surgery. You are usually discharged the next day.

What risks or complications are associated with the procedure?

All surgical procedures may be associated with some risk. Although green light laser prostatectomy is a relatively safe procedure, complications that can occur include haematuria (blood in urine), dysuria (pain while urination),urinary tract infection, retrograde ejaculation (semen flows back into the urinary bladder rather than coming out through the urethra), erectile dysfunction and incontinence (<1%).

What are the advantages of green light laser prostatectomy?

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

• Minimal blood loss
• Safer for patients on anticoagulation therapy who cannot safely stop these medications such as warfarin and clopidogrel
• Quicker recovery than the traditional TURP

What are the disadvantages of Greenlight Laser Prostatectomy?

• The duration of the surgery takes longer than the traditional TURP
• The patient may experience more irritative voiding symptoms such as frequency, urgency and dysuria after the operation
• This operation not suitable for patients with large prostates
• Removed prostate tissue is vaporised, so it cannot be analysed for cancer