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General overview

GreenLight™ Laser PVP (photoselective vaporization of the prostate) is one of many laser techniques used by urologists to remove excess prostatic tissue in patients who have been diagnosed with BPH (benign prostatic hypertrophy), which is a non-malignant enlargement of the prostate. 

This excess tissue is removed because BPH leads to decreased urinary flow due to its obstructive nature. The major complication of BPH then is that it can cause post-obstructive renal failure.

The first surgical technique that was used to remove excess prostatic tissue was called a TURP (trans-urethral removal of the prostate). This technique is still being done in many hospitals worldwide and involves scraping prostatic tissue with a instrument that's passed into the urethra through a scope.

PVP vs TURP

PVP is done by inserting a laser tube through the scope that enters the urethra and then specifically applying light impulses to the abnormal tissue in order to get rid of it.

Since heat is being applied, blood vessels are also being cauterized and there's therefore less bleeding involved as compared to the TURP procedure. 

PVP also involves a shorter anaesthetic time, indwelling catheter duration and hospital stay as compared to the TURP procedure. PVP and other laser procedures also seen as being much safer options for dealing with symptomatic BPH.

Major benefits of PVP

Besides the benefits already mentioned when compared to TURP, PVP has other benefits for the patients and these include the following.

  • Patients can resume their normal activities within 2-3 days and rigorous activities can be resumed within 4-6 weeks.
  • There's long-term success in improved urinary flow.
  • Patients experience fewer urinary tract obstructive symptoms.

Possible side-effects and complications of PVP

Unfortunately, not all procedures are 100% complication and side-effect free and there are some risks that the patients take when undergoing these procedures.

As long as the health benefits of the procedure outweigh these risks, then one would suggest to continue to be treated for the offending condition.

The issues which can occur include the following:

  • Urinary tract infections - this is usually due to the indwelling catheter which is placed after the procedure.
  • Temporary difficulty in urinating - there may be issues with urinating properly for a few days after the procedure.
  • Narrowing of the urethra - scar tissue can form where the procedure was done and this can cause a possible obstruction which may need additional treatment.
  • Retreatment - besides scar tissue being present, the abnormal tissue may grow back and this would then require the patient to be treated again.
  • Retrograde ejaculation - ANY prostate surgery can lead to this issue and does seem to be a common occurrence. Retrograde ejaculation is when, during sexual climax, the semen is released into the bladder rather than out the penis. This issue will never cause any problems unless one is still trying to father children. In this case, you would need to discuss this with your urologist.
  • Erectile dysfunction - there is a small chance that a patient's ability to get and maintain an erection may be affected with these procedures.
It's important to take note that although there is a chance of these issues arising, the risk of them occurring with laser techniques as opposed to the traditional procedures is decreased tremendously.

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