Greenlight Photovaporization of the Prostate (PVP) is a minimally invasive surgical procedure to relieve urinary symptoms from an enlarged prostate, a common, non-cancerous condition called Benign Prostatic Hyperplasia (BPH). BPH affects many men as they age. This procedure is a modern alternative to more traditional surgical methods for BPH.
The Greenlight Laser Technology
Benign Prostatic Hyperplasia causes the prostate gland to enlarge and squeeze the urethra, obstructing urine flow and leading to symptoms like a weak stream and frequent urination. Photoselective vaporization addresses this obstruction by removing excess prostate tissue. This creates a wider channel for urine to pass through.
Greenlight PVP uses a laser emitting a 532-nanometer wavelength of light. This wavelength is highly absorbed by hemoglobin but not by water. This selective absorption allows the laser to rapidly heat and vaporize targeted prostate tissue.
As the laser vaporizes obstructive tissue, it simultaneously heats and seals surrounding blood vessels. This coagulation effect is a feature of the Greenlight system that leads to significantly less bleeding. The process carves an open channel, relieving pressure on the urethra.
The Surgical Process
Ideal candidates for Greenlight PVP are men with moderate to severe urinary symptoms from BPH. The procedure is well-suited for those wanting a treatment with a lower risk of bleeding, including patients on anticoagulant medications. A urologist considers the prostate’s size and shape and the patient’s overall health to determine suitability.
The procedure is performed on an outpatient basis under either general or spinal anesthesia. During the surgery, a urologist inserts a thin, lighted instrument called a cystoscope through the urethra to visualize the prostate.
A slender laser fiber is passed through the cystoscope to deliver energy to the enlarged prostate tissue. The energy vaporizes the tissue, clearing the obstruction. At the conclusion of the surgery, a soft urinary catheter is inserted to drain urine from the bladder while the area heals.
Post-Procedure Recovery and Outcomes
The urinary catheter is kept in place for a short period and is often removed within 24 to 48 hours. Patients are advised to avoid heavy lifting and strenuous activities for a few weeks to allow for proper healing. While many men notice an immediate improvement in their urinary stream, full benefits may take several weeks to materialize as post-operative inflammation subsides.
Temporary side effects are common and can include urinary frequency, urgency, or a mild burning sensation during urination. A potential long-term side effect is retrograde ejaculation, where semen enters the bladder during orgasm, resulting in a “dry” orgasm. While the risk of new-onset erectile dysfunction or urinary incontinence is low, these are also possibilities.
The results of Greenlight PVP are durable, providing long-lasting relief from BPH symptoms and improved quality of life for many years. Because the prostate can continue to grow, a small percentage of men may require retreatment in the future.
Greenlight PVP vs. Other BPH Surgeries
Compared to Transurethral Resection of the Prostate (TURP), the traditional surgical standard for BPH, Greenlight PVP involves less bleeding, a shorter hospital stay, and quicker catheter removal. TURP, which involves physically cutting out and removing tissue pieces, may still be recommended for men with very large prostates.
Other minimally invasive options like UroLift and Rezum are tissue-sparing procedures often chosen by men who wish to preserve sexual function due to a lower incidence of ejaculatory side effects. As a tissue-removal procedure, Greenlight PVP provides a more substantial and durable improvement for patients with significant urinary obstruction.