What is the Prostate?
The prostate is a gland that is part of the male reproductive system, which is located around the urethra and below the urinary bladder. It is an endocrine gland that secretes fluids that provide nutrients and protection to sperm, which are transported from the testicles into the ejaculate.
What is Benign Prostatic Hyperplasia?
The prostate gland starts to grow at the age of 25 and continues growing as a manages. The urethra encircling the enlarged prostate gland gets compressed causing obstruction to the flow of urine. This condition is referred to as benign prostatic hyperplasia (BPH) and is a common problem in men. BPH is a non-cancerous condition.
BPH can lead to problems in urination such as:
- Nocturia (increased urination at night)
- Urgent and frequent urination
- Weak urine stream
- Incomplete emptying of the bladder
- Trouble starting urination
- Dribbling at the end of urination
BPH may further lead to kidney, bladder or urinary tract problems.
Treatment of BPH
Benign prostatic hyperplasia can be treated through:
- Lifestyle modifications, such as reducing alcohol and caffeine intake, performing pelvic floor muscle strengthening exercises
- Surgical intervention
- Transurethral resection of the prostate (TURP)
- Laser therapy
What is Greenlight Laser
The Greenlight laser procedure uses a crystal of potassium titanyl phosphate (KTP) to produce a beam of green light at a wavelength of 532 nanometers to reduce the size of the prostate gland.
Indications for Greenlight Laser
Transurethral resection of the prostate (TURP), a surgical procedure that involves excision of a section of an enlarged prostate gland, using high energy electric current, is considered the standard of care but is associated with perioperative complications in surgically high-risk patients who have pacemakers, using platelet antiaggregant and anticoagulant medications. The Greenlight laser is an alternative minimally invasive procedure that is considered for the treatment of benign prostatic hyperplasia. It is indicated for people with the following conditions:
- Excessive urination urges
- Difficulty starting or controlling urination
- Prolonged urination
- Can be performed even if you take blood thinners or have a pacemaker, neurostimulator or defibrillator implanted
It may also be recommended if you have recurrent urinary tract infections, kidney or bladder damage, blood in urine and bladder stones.
Preparation for Greenlight Laser
Your doctor may instruct you to empty your bladder before the laser treatment. Then, you will be taken to the procedure room where you will lie on your back for the procedure.
Greenlight Laser Procedure
The procedure is performed under general or spinal anesthesia with sedation. A scope (a narrow lighted tube) is inserted into the urethra for your surgeon to be able to view the inside of the urethra, bladder, and prostate. The scope is extended until it reaches the level of the prostate. The greenlight laser is then guided through the scope and targeted on the overgrown prostate. The energy of the greenlight laser is absorbed into blood circulating in the prostate and vaporizes the excess prostate tissues. The laser has a short depth of penetration and does not harm the underlying tissues. Once the urethral blockage is cleared, your surgeon removes the laser and scope. A catheter may be inserted to drain urine.
What to Expect after Greenlight Laser
After the procedure, you are usually discharged within a few hours. The dead tissue that is not immediately vaporized will be excreted through your urine in the initial days following your surgery. You will experience relief from the discomfort associated with urination along with considerable improvement in urine flow, usually within 24 hours of the procedure, and can resume your daily activities soon after the procedure.
You may notice traces of blood in the urine, or experience a greater urge and frequency to urinate, or a burning sensation while urinating for an about a week after your treatment. These will resolve with time.
Risks and Complications of Greenlight Laser
As with most procedures, the Greenlight laser may be associated with certain risks and complications such as:
- Retrograde ejaculation, where the semen flows backward into the bladder instead of exiting through your penis
- Incontinence, where you have trouble holding your urine
- Erectile dysfunction, where you cannot hold an erection
- Stricture or scar tissue formation, which is usually rare
Greenlight laser has the following advantages:
- Quick procedure
- Shorter catheterization time
- Usually an outpatient procedure
- Faster recovery
- Minimal to no blood loss
- Fewer complications compared to TURP