Surgical intervention may be required for benign prostatic hyperplasia when drug therapy has not worked, the patient cannot tolerate medication or if the prostate is very large. By far the most common indication for intervention is when the symptoms trouble a patient enough that he wants something done. Another common reason for intervention is the development of urinary retention which is the inability to urinate which may require a catheter to be placed through the penis into the bladder.

A newer surgical technique to treat BPH has been developed called Greenlight laser photoselective vaporization of the prostate (PVP). In this operative procedure, a laser fiber is used to vaporize the enlarged portion of the prostate. This is generally done as an outpatient (same day surgery) procedure.  The catheter is generally left in overnight at the discretion of the surgeon. Generally, patients experience a stronger urinary stream immediately following surgery, however irritating urinary symptoms can persist for a period of time.  During the first one to three months after surgery, patients may experience ongoing frequency and urgency of urination and occasionally slight burning with urination.  This generally occurs as the operative site just below the bladder continues to heal.  Once the healing is complete, these symptoms abate.

Before your Procedure

Typically patients will be asked to stop blood thinners such as Coumadin, Eliquis or Lovenox ahead of the procedure.

Most patients will continue their BPH medications up to, and for a brief period after the procedure.

If you take aspirin or ibuprofen or other OTC vitamins, you can usually continue them but please check with your provider or schedulers to confirm

You will have a urine analysis approximately 7-10 days prior to the procedure to ensure that no infection is present

Description of Procedure

The Greenlight laser utilizes laser or light energy to vaporize redundant and obstructing prostate tissue. The procedure is typically done as an outpatient procedure in a surgery center or hospital under general anesthesia. There are no incisions and a specialized scope is advanced into the urethra and the laser fiber is advanced through the scope. The surgeon directs the laser energy at the obstructing prostate tissue. The tissue absorbs the light energy and is then vaporizes. This process is carried out until the obstruction caused by the prostate has been adequately treated.

You can expect to be in the surgery center for up to 2.5 hours. The Greenlight laser PVP procedure itself takes less than 45-90 minutes, depending on prostate size. Most patients are discharged with a catheter which is removed the following morning.

After your Procedure

What to Expect After your XPS Greenlight Laser PVP Procedure

  • You will experience a mild burning sensation with urination for 3-4 weeks
  • You may see blood in your urine on and off for several weeks and sometimes longer
  • You may have experience increased frequency of voiding for several days or find that you have to strain to empty your bladder
  • A follow up appointment will be scheduled for 4-6 weeks to check urine for infection and to obtain a post void residual (PVR) to ensure that your bladder is emptying adequately
  • It’s not unusual for your symptoms to get worse in the short term as a result of the procedure. This process usually takes 4-6 weeks after which you should see an improvement in your urinary symptoms.

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