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 not bleed.

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:

1. PVP patients are able to go home the same day.  TURP usually requires a one to three night stay in the hospital.
2. There is less bleeding and subsequent blood loss with PVP.  Patients on blood-thinning medications have been safely treateed with PVP while on those medications.
3. 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.
4. The chance 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.
5. 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 percent faster! 

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.

Contact us at (707)224-7944 if you would like to arrange for a consultation to see if you would benefit from any of these techniques.