ESWL :: Flexible pyeloscopy and laser :: Ureteric Stent :: Cystoscopy
TURP :: Greenlight laser prostatectomy :: Retrograde pyelogram

Greenlight Laser Prostatectomy is a safe, effective and efficient treatment to ease urinary symptoms in patients with benign prostatic enlargement (BPE). It is a minimally invasive procedure which utilizes a 532nm wavelength laser to remove excess prostate tissue blocking the urethra by vaporization. This laser appears green in colour so this surgery is also called Greenlight Laser Therapy. The laser with this specific wavelength is chosen as it is selectively absorbed by vascular prostate tissue and poorly absorbed by water. The procedure is also known as Photoselective Vaporization of the Prostate (PVP).

Advantages

Greenlight Laser Prostatectomy has several advantages over other treatment procedures for benign prostatic enlargement and they include:

• Minimal blood loss. It virtually causes no bleeding as the laser creates a 1-2 mm zone of coagulation necrosis around the area of vaporization. The laser also cauterizes the ruptured blood vessels during the surgery to control any bleeding
• Offers immediate symptomatic relief and significant improvement in urine flow after the surgery
• It is a safe procedure with few complications and short stay in hospital
• The procedure is also safe and effective for patients on anticoagulation therapy

It is common for the prostate gland to become enlarged as a man ages. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to constrict the urethra. This leads to a number of urination and bladder problems such as urinary hesitancy, frequent urination, urinary tract infection and urinary retention. This is referred to as Benign Prostatic Obstruction (BPO). The symptoms of obstruction are more common in men above 60 years of age.

Surgery is beneficial in these patients to remove the excess prostate tissue blocking the urethra to ease the urinary symptoms.

GreenLight Laser Prostatectomy is performed under general or spinal anaesthesia. The laser is delivered through a flexible fibre passed through a cystoscope, a tube like instrument with a light and a camera at one of its ends. The cystoscope along with the flexible fibre is inserted through the urethral opening of the penis. The real time images from the cystoscope are displayed on the monitor in the operating room. The surgeon controls the direction and delivery of the laser energy through the flexible fibre tube, under the guidance of real time imaging. Laser energy is delivered as small bursts, lasting for a few seconds, to vaporise the prostate tissue. Continuous flow of irrigation fluid is maintained to keep the fibre tip cool and to maintain a clear view of the operative area. The cystoscope with the fibre is slowly manipulated through the urethra, removing the obstructing prostate tissue thereby enlarging the space within the urethra and restoring normal urine flow. At the end of the procedure a catheter is placed in the bladder and is usually removed the next day after surgery. Patients are discharged from hospital once they are able to pass urine well, usually on day 1 after surgery.