Photo-selective Vaporization of Prostate (PVP) is increasingly becoming a popular method of treating benign prostatic enlargement (enlarged prostate or BPH). Using a combination of a high-powered laser beam and fiber optics to vaporize overgrowths of cells in the prostate, PVP helps to shrink the prostate gland quickly and accurately and swiftly relieves symptoms of Benign Prostatic Hyperplasia. The GreenLight Laser PVP is an alternative to the more common TURP (Transurethral Resection of Prostate). While the PVP procedure offers equal effectiveness in improving BPH symptoms, it’s simpler, has minimal short-term side effects, and offers quicker symptom relief, comfort and ease of urine flow.
How Is The Procedure Performed?
Conducted as an outpatient procedure by a urologist trained in the technique, the GreenLight Laser PVP requires nerve-blocking, spinal or general anesthesia along with sedation. During the procedure, the urologist inserts a cystoscope (tube supplied with light) via the urethra into the prostate, then runs a thin fiber through the cystoscope and places it in the urethra just adjacent to the obstruction. The urologist directs the laser at the prostate with intense pulses of light radiating from the ends of the fiber that are absorbed by blood.
As the blood absorbs light its temperature increases rapidly, heating up and vaporizing nearby cells. The surgeon continues to apply the laser light to destroy tissue overgrowth and reduce restriction on the urethra. The tissue that’s evaporated seals the blood vessels and reduces bleeding. The procedure takes roughly 40-60 minutes and a temporary catheter is usually inserted to help drain urine from the bladder.
So what are the benefits of Laser PVP?
- Minimal bleeding.
- Patients return home the same day.
- Return to normal activities in 2-3 days with caution.
- Only about 30 percent of patients require a post-op catheter.
- Return to strenuous activities in 4-6 weeks.
- Complications are rare, but quite mild if they occur.
- No post-operative impotence.
- PVP has not been associated with erectile dysfunction.
- Less likely to cause retrograde ejaculation.
- Lasting improvement in urine flow.
- Urinary obstruction is less likely with PVP.
Recovery after GreenLight Laser PVP
After laser PVP, patients remain in a recovery area where they are observed and prepared for discharge, typically within a few hours. If a temporary catheter is inserted, it’s usually removed 2-3 days after treatment, but may be left for a longer period in men who have had very severe symptoms or suffered prior bladder damage. During the first week following the procedure, a slight burning and discomfort may be experienced when urinating and small amounts of blood may occur in urine. While a dramatic improvement of symptoms and urine flow occurs within 1-2 days after the procedure, patients may still experience frequency and a sudden urge to pass urine for some time after treatment since the urethra is still adjusting to changes. And those with multiple health problems may not realize improvement that quickly.
Many men resume normal activities three days or so after laser PVP, but it’s recommended that they refrain from heavy lifting, pushing, strenuous exercise and vibrating equipment for at least 2 weeks because such activities may aggravate the urogenital area and cause bleeding. Sexual activity should be avoided for 2-3 weeks and only resumed when the patient is really comfortable doing so. It’s crucial to take things slowly and realize that it’ll take a while to get everything back to normal, including sexual desire. At times, retrograde ejaculation or reduced volume may occur, but these do not affect sexual pleasure or orgasm.
Is Laser PVP Safe?
The GreenLight Laser PVP is a significant improvement on the other minimally-invasive procedures used to treat BPH. It accurately vaporizes the overgrowth of the prostate gland without damaging any surrounding tissues and vessels. High-powered energy beams are delivered through a very thin laser fiber resulting in safe and precise vaporization of the overgrown tissue that’s blocking normal urine flow. As the high-pulsed laser removes the tissue causing blockage, it coagulates blood vessels and minimizes bleeding. Compared to other options for treating BPH, the GreenLight Laser PVP is much safer, simpler, faster, more precise and more effective. And most importantly, it allows quicker recovery than the other treatment options.
How does laser PVP compare with TURP?
Previously, effective BPH treatment required open prostatectomy — a major abdominal operation that needed a longer hospital stay and several months for recovery. But with the availability of instruments for accessing the prostate via the urethra instead of through the abdomen, TURP (transurethral resection of prostate) became the preferred treatment as it offered more safety, efficiency and effectiveness. However, there was still need for a better treatment that could offer quicker results, shorter recovery times and fewer long-term side-effects. The GreenLight Laser PVP has proven an improvement on TURP by being less invasive, delivering more immediate results and providing shorter recovery periods.
At St Pete Urology, we recommend transurethral vaporization procedures, most commonly the PVP GreenLight Laser and HoLAP (Holmium Laser Ablation), as alternatives for the previous gold standard TURP (Transurethral Resection of Prostate) because they are minimally-invasive outpatient operations with lower risks, durable results, safe use on large glands and patients on blood thinners, and high patient satisfaction. We perform the PVP GreenLight Laser on patients eligible for TURP, but discuss all the treatment options with our patients before we make a choice. For more information on treatment and care for BPH, visit the “St Pete Urology” site.
