Understanding GreenLight Laser Therapy
Benign Prostatic Hyperplasia (BPH)
BPH or benign prostatic hyperplasia or hypertrophy is a benign enlargement of the prostate. The prostate is located below the bladder and surrounds the urethra (urinary channel). Its main function is to produce fluid that transports sperm during ejaculation. In many middle-aged men the prostate begins to grow for reasons not fully understood. This benign growth can cause many urinary symptoms in men.
As the prostate enlarges it impinges upon the urethra. This pressure can obstruct urinary flow and elicit urinary problems such as:
- Nocturia, frequency at night
- Weak urinary stream
- Urgency, sudden urge to urinate
- Incomplete bladder emptying
- Dysuria, burning with urination
- Retention, inability to urinate
In many instances these symptoms can diminish or resolve with the use of medications. Typically, an alpha blocker such as Flomax or Doxasozin is used in combination with an alpha reductase inhibitor such as Proscar or Avodart for maximal medical management. These are safe medications that many men stay on for years without difficulty. But often these medications lose their efficacy or don't relieve the symptoms well and further treatment is necessary. Surgical intervention is the next step.
GreenLight Laser Therapy
GreenLight laser is a more recent technology with replaces the 'traditional' TURP (transurethral resection of the prostate) procedure. GreenLight laser therapy is a procedure performed with a small fiber introduced into the urethra with a cystoscope, a flexible scope with a camera on the end. The fiber delivers high power laser energy which heats up the prostate tissue, leading to tissue vaporization. The procedure is performed until all of the enlarged prostate tissue has been removed.
The advantages of the GreenLight laser therapy is quick urinary flow improvement and resolution of accompanying urinary symptoms, less recovery time, less blood loss, long lasting treatment, and shorter catheterization time.
Common risks and side-effects of GreenLight laser therapy is hematuria (blood in the urine), bladder spasms or urgency, frequent urination due to bladder irritation, dysuria (burning with urination), and retrograde ejaculation (some or all of your ejaculate goes backwards into the bladder instead of forward through the urethra), rarely incontinence.
Your surgery will be performed under general anesthesia and typically takes 1-2 hours. A foley catheter (drainage tube in your bladder) will be left in place and you will stay one night in the hospital. The catheter is usually removed prior to discharge the next day. In rare instances some men may go home with a catheter for a couple of days and return to the hospital to have it removed. You will be given pain medication and stool softner's to go home with.
Most men experience an improvement in the urinary flow rather quickly. However you may continue to experience urinary symptoms of dysuria (burning with urination), hematuria (blood in the urine), urgency, frequency secondary to the procedure itself. These symptoms typically resolve over 1-2 weeks or less, with occasional men experiencing these symptoms for many weeks. You will follow up with your doctor one month after surgery to evaluate how you are recovering physically as well as your urinary flow recovery.
You should contact your doctor if you experience a large amount of bright red blood or clots (quarter size) in your urine. If you have a temperature greater than 101.5, nausea, vomiting, chills or shaking. Inability to urinate.
If you are one of the few men who is discharged from the hospital with a catheter in place please call your doctor if your catheter stops draining.