Green light laser surgery for the prostate refers to Photoselective Vaporization of the Prostate using a green light laser (also known as KTP laser). It is used in the treatment of Benign Prostatic Hyperplasia or more commonly known as enlargement of the prostate gland.
Green
light laser treatment is a minimally invasive therapy that evaporates prostate tissue which is blocking the flow of urine from the
bladder. It uses a unique high power laser energy which is selectively absorbed by blood within the prostate tissue which leads to
vaporization and removal of the tissue, leading to an open channel for passage of urine. At the same time, the laser seals blood vessels
beneath the area of vaporization which results in substantially less bleeding, compared to traditional traditional transurethral resection
of prostate (TURP). There are much fewer side effects and recovery is much quicker.
In most cases, patients will have either general anesthetic or spinal anesthetic with sedation. The choice should be made in consultation
with the patient, urologist and the anesthesia provider.
Following anesthesia, a scope will be passed via the urinary opening from external into the urethra, prostate and bladder. The green light laser fiber is introduced via the scope and treatment is commenced. No surgical incision or cut is required on the body.
The treatment time is about 1-2 hours, depending on the size of the prostate.
At
the end of treatment, a small rubber tube called a catheter is replaces the scope. The tube drains urine directly from the bladder
into a bag.
While Green Light Laser has fewer complications than traditional prostate surgical treatments, side effects of the treatment still
occur. The Green Light laser has been shown to have shorter hospital stays and fewer complications. As with all prostate surgery,
sexual side effects may include retrograde ejaculation and in rare instances, erectile dysfunction (impotence, about 1%). Rare episodes
of strictures (scar tissue build up) have been noted in urethra (urine tube).
This treatment is suitable for almost all patients with prostate enlargement who require surgery or not responding to medical (drugs) therapy. Prostate drugs are initially prescribed to patients with enlargement but some patients will progress and will require surgery. Surgery is also needed in patients who have complications such as bladder infection, bladder stone, inability to pass urine (retention) or kidney failure.
As green light laser has the additional ability to control and decrease bleeding during surgery,
it has advantage in patients who are taking blood thinning medications such as Aspirin or patients who are taking anti-coagulation
drugs such as Warfarin.
The catheter will be removed within 24 hours and normal urine passage resumes. The expected hospital stay is usually only one night.
Small amount of blood may be seen in the urine and it will lighten to normal color within a few days. A person can return to work within 4-5 days.