Green Light Laser
Benign prostatic growth
can cause serious difficulty with urination as men age. About
50 percent of men will experience a change in their pattern
of urination during their lifetime because of this benign growth. Further
information on BPH can be found on the BPH page of this website.
The new gold standard for surgical treatment of BPH is photoselective vaporization
of the prostate (PVP), more often termed green
light laser prostatectomy. This is a minimally invasive procedure
that results in dramatic improvements in urinary symptoms from BPH. It
is usually done as an outpatient procedure in a hospital or surgery center
under general or spinal anesthesia.
PVP works by using a laser with a green wavelength to vaporize the prostate
tissue. The obstructing prostate tissue is effectively removed just
as well as it can be by the old gold standard known as a TURP, or transurethral
resection of the prostate. PVP is less invasive than a TURP is because
the prostate tissue is selectively vaporized rather than cut. When the
prostate tissue is cut with an electrical loop in a TURP, the prostate will
bleed during the procedure. During PVP of the prostate, the tissue does
The green light laser used
in PVP has a wavelength that is maximally absorbed by hemoglobin,
which in present in red blood cells. Because of this,
tissue that has blood in it (like the prostate) is selectively
vaporized. The vaporization of the tissue
with hemoglobin is done bloodlessly. Vaporization will
continue as long as the BPH tissue is painted by the laser. Once
the capsule of the prostate is reached, vaporization ceases,
and the procedure is complete. The prostatic capsule
is fibrous and has no hemoglobin, so it is protected by the
properties of the laser.
Advantages of PVP over TURP:
patients are able to go home the same day. TURP
usually requires a one to three night stay in the hospital.
is less bleeding and subsequent blood loss with PVP. Patients
on blood-thinning medications have been safely treateed with PVP
while on those medications.
Less fluid is absorbed by the
body in PVP. A small
percentage of patients during TURP will absorb enough
to get water overload in their blood, causing hyponatremia
(low sodium levels in the blood), which can have harmful
affects on the body. This does not happen with PVP.
of having erectile problems after TURP, while uncommon at 5
percent, is rarely seen and is less than 1 percent. Dr.
Hendricks has never seen a patient have new onset erectile
problems after PVP.
The improvement in symptoms after PVP
using the AUA symptom score and maximal urinary flow
rate are equivalent to TURP.
The safety and efficacy of
PVP have indeed made it the new gold standard
in the treatment of BPH.
As of late May 2006,
the newer generation green light laser has become available
and is being used. This laser is more powerful and
just as safe as the older generation laser. This is
advantageous because the procedure can now be done quicker. With
the older machines, the procedure can take 2 hours or more
to perform, depending on the size of the prostate. The
newer machines are able to vaporize the prostate 30 to 50
Dr. Hendricks has performed well over 200 green light laser prostatectomies
and has seen tremendous results with the procedure. The majority of patients
have had significant improvement of their urinary symptoms. Only 3 patients
to date have not experienced benefit from the procedure, for a success rate
of 98.5 percent!
For more information on what you need to know before what to expect after the
procedure click here.