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Photoselective Vaporization Of The Prostate

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What Are The Alternatives To Photoselective Vaporization Of The Prostate

Meet Seth K. Bechis, MD: Urologist

There are medical treatments that are available to treat this condition. Other surgical alternatives are Transuretheral Resection of the Prostate or TURP. In rare cases of an exceptionally large prostate gland, patients may benefit from a major surgical procedure to remove larger volumes of prostate tissue. There are on-going clinical trials at the University of Colorado for other minimally invasive treatment alternatives. Should you have any questions about these please consult your physician.

Enlarged Prostate Treatment Options

When symptoms begin to interfere with your lifestyle, its time to consider treatment choices. Understanding your options will help you make the right choice for your desired outcome and lifestyle needs. Discuss this information with your urologist.

GreenLight is suitable for most patients with an enlarged prostate. With over 200,000 procedures performed worldwide, the GreenLight procedure is creating a new standard of care a standard that offers freedom from enlarged prostate symptoms.

Postoperative Course And Complications Within 30 Postoperative Days

Figure 1 shows perioperative outcomes. Data from 8 available studies showed a longer postoperative catheterization time and length of stay in the TURP group : 1.12, 95% CI:1.091.14, p< 0.00001 and RR: 1.16, 95% CI: 1.121.19, p< 0.00001, respectively). Data from ten studies of 1689 patients compared the need for blood transfusion and showed a higher risk of transfusion in the TURP group . Data from ten studies including 1628 patients showed no difference in the risk of urinary tract infections between the two groups . Data from eight studies including 1923 patients showed a non-significant higher risk of transient re-catheterization in the TURP group . Data from eight study including 1705 patients showed a significant risk of higher dysuria/urgency in the Green Light PVP group

Figure 1 Postoperative course. Postoperative catheterization Length of stay Blood transfusion Urinary tract infection rate Re-catheterization Dysuria/urgency incidence.

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Where To Get Greenlight Pvp Prostate Laser Surgery In Nyc

At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.

or make an appointment online.

We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.

Our appointment costs are affordable with or without insurance. We offer free insurance verification.

How Greenlight Laser Prostatectomy Works

Modified Vaporization

GreenLight laser prostatectomy is a procedure in which the excess prostate tissue is removed to relieve constriction of the urethra, allowing easy passage of urine.

The laser is used to vaporize excess prostate tissue that is limiting the flow of urine. Most patients can expect very rapid relief of their BPH symptoms, often within 24 hours of GreenLight Laser prostatectomy.

For most men, GreenLight laser prostatectomy is an outpatient procedure, allowing them to return home the same day.

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Incidence Of Treatment Failure

The primary outcome, treatment failure, was defined as any subsequent surgical reintervention or any emergency acute urinary retention event after the initial procedure. The median follow-up time was 2.8 years.

At seven years, the unadjusted cumulative failure rates were 15% for TURP, 14% for PVP, 7% for EEP and 18% for other procedures .

Perioperative And Postoperative Features

Generally, no intraoperative complications were recorded. Two patients experienced early postoperative complications . Median catheterization and hospitalization time was 2 days .

Functional outcomes 6 months after surgery are shown in Supplementary Table 2.

Median Hb, PSA, Qmax was 0,60 g/dl, 1.56 ng/mL, 18.5 mL/s, respectively.

Comprehensively, we recorded a meaningful post-operative improvement in both storage and functional symptoms as well as in global quality of life scores at validated questionnaries .

A significant inverse correlation between the amount of energy delivered on the prostatic tissue and the degree of improvement of LUTS was detected considering the entire surgical procedure. The same analysis applied to the individual steps of the aPVP procedure confirmed a significant inverse correlation for all steps regarding the general improvement in IPSS, while only for steps 1-3 regarding the imporvement in storage LUTS .

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Strengths And Limitations Of This Study

  • This updated meta-analysis included a larger number of studies involving more participants which adds precision to previous findings.

  • This study analysed both safety and efficacy, focusing on sexual functioning and quality of life measures because lower urinary tract symptoms treatment related adverse events have a hugely detrimental impact on ones psychological well-being.

  • Quality assessment methods used did not highlight substantial differences between studies because blinding is not possible given the characteristics of the two interventions under investigation.

  • Due to the limited number of studies in this field, we were unable to conduct subgroup analysis around laser power which is necessary to identify the most effective/efficient standard.

  • Surgical experience with laser technology, drop outs and withdrawals as well as other important factors were seldom reported in any detail which inhibits further analysis.

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Psa And Prostate Configuration

Green Light Laser Therapy, What are the Benefits – Dr Evan Fynes

PSA has been considered as a predictor of success of PVP. Te et al. suggested that there is a significant difference in efficacy in patients with a PSA of 6.0 or 6.1 ng/mL before PVP . Although those with PSA of 6.0 ng/mL had significantly superior postoperative urinary flow rate and post void residual, those with total Prostate Specific Antigen 6.1 ng/mL still had acceptable outcomes. It is probable that these results reflect larger prostate volumes in the group with the higher tPSA value. Te et al. used the 80 W laser and it is possible that greater de-bulking of the larger prostates would be possible with the higher powered 180 W laser now available.

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Is Greenlight Laser Pvp Treatment Right For Me

GreenLight Laser PVP is a recent addition to the minimally invasive techniques in the treatment of BPH. The procedure uses the technology of high-powered laser light combined with fiber optics to vaporize the overgrowth of prostate cells quickly and accurately. As the surgeon directs the laser at the prostate, the intense pulses of light emitted from the fiber are absorbed by the blood. Within moments, the temperature of the blood becomes so great it causes the nearby cells to vaporize. GreenLight is being used as an alternative to transurethral resection of the prostate and has been shown to be its equal in terms of effectiveness in an improvement of symptoms. There is growing interest in this technique by patients and practitioners because of its simplicity and efficiency. GreenLight stands alone in its ability to give patients quick symptom relief, ease and comfort of urinary flow, and minimal short-term side effects. This technique is too new for long-term studies to have been completed, but after five years it has been shown to maintain its level of improvement in urinary flow and comfort, and for giving men the quality of life they deserve.

Data Extraction And Statistical Analysis

Preoperative parameters were extracted together with intraoperative data including operation times, changes in haemoglobin and transfusion rates. Postoperative data including length of hospitalisation, duration of catheterisation and treatment-related complications were also analysed. Functional results including IPSS, Qmax, PVR, QoL and IIEF were assessed at 3, 6, 12, 24, 36 and 60 months after surgery.

Mean difference was used to assess continuous parameters. Authors were contacted when data were expressed as medians with corresponding range values. Otherwise, the statistical formula elaborated by Hozo et al was implemented to back-calculate means and SD in accordance with the recommended methods described in the Cochrane Handbook for Systematic Reviews.

Results were expressed as risk ratios with corresponding 95% CI for dichotomous variables. I2 was utilised to assess heterogeneity across studies. An I2< 50% is generally considered an acceptable level of heterogeneity therefore a fixed effect model was applied. In instances where the I2> 50%a random-effects model was applied as is the standard procedure for higher levels of heterogeneity. Pooled effects were synthesised using Z test and a p value < 0.05 was set at the threshold for statistical significance.

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Enlarged Prostate Laser Surgery: Recovery Side Effects And Natural Treatment

Prostate enlargement is a common feature in males over fifty years of age. Prostate is a gland at the base of the urinary bladder and around the urethra. It is in a size of large chest-nut. Most common enlargement of prostate is benign enlargement of prostate. It is non-cancerous and usually causes obstruction of urine outflow, increase in frequency of urination especially in night and dull pain below umbilical region. Cancerous enlargement is dangerous and can spread to surrounding organs.Enlargement can be due to exposure to cold and chill, infectious diseases, excessive sexual excitement, constipation etc. Prostate problems affect many men, especially those in their senior years.

The laser procedure has its fair share of advantages and disadvantages. Still, in most cases, the advantages far outweigh the disadvantages. This is especially true if the procedure is done by a trained and licensed medical professional using FDA approved laser equipment.

Laser surgery is minimally invasive thus the chances of bleeding are minimal. This means that the procedure can also be done on those who are taking blood thinners and those who have bleeding disorders. Laser surgery can correct an enlarged prostate.

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How Soon Can I Return To Work And Other Activities After Greenlight Laser Procedure For Bph

Photoselective Vaporisation of the Prostate Using 80

Most men can return to office work a few days after Greenlight laser surgery for enlarged prostate. Men who drive or engage in potentially dangerous situations should wait until they are comfortable with their urinary function before returning to work. In other words, once urinary urgency and frequency are tolerable and compatible with your work situation, you may safely return to work.

jim0601

I had GL surgery four days ago and would appreciate feedback regarding the recovery process from those that have also undergone this procedure. I currently void every 30 to 60 minutes at night and every 30 to 60 minutes during the day. My flow is a stream for a few seconds then dribbles for maybe 30 seconds. Is this pretty typical? After the surgery I was drinking 1 1/2 liters of water per day but I may reduce this because I am not convinced my bladder is emptying fully. What do you think about this? When I void, it really burns at first and often I will get bladder spasms as well. Do you think the pain is radiated pain from where the prostate was vaporized? Do you think I will see improvement with these symptoms on a daily basis or weekly basis over the next month or so?

3 likes, 163 replies

  • Posted 4 years ago

    I have had the surgery 2010 and since been having problems with bladder not emptying it sounds like Im going to have it redone again

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    What Are The Complications Of This Procedure

    Uretheral discomfort as mentioned above. Bleeding as mentioned above. An infection of the bladder or kidney is a possibility but is unlikely, urinary leakage is a rare but potentially disabling complication. There is a about a five percent chance that this could effect the ability to obtain normal penile erection after the surgery. A very common complication after the surgery is a lack of ejection due to the change in the opening between the bladder and the prostate caused by the procedure. A narrowing in the urethra called a stricture is a complication that can result in other minor procedures. Additionally, areas of the prostate may continue to grow and cause future obstruction after the procedure.

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    What Is Photoselective Vaporization Of The Prostate

    This is a procedure that attempts to alleviate urinary symptoms caused by benign enlargement of the prostate gland. The enlarged prostate can compress the urethra and cause bothersome urinary symptoms. The procedure removes prostate tissue by using a laser to turn the tissues into gas. This allows easier urinary flow. Similar techniques such as Transuretheral Resection of the Prostate have been successfully used to treat symptomatic benign prostate enlargement for several decades. The TURP procedure does result in patients having to stay in the hospital for a day or two as it is associated with more bleeding and other complications. The use of the laser has allowed us to operate with less concern for bleeding allowing for outpatient surgery in most cases.

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    Comparison Of Photoselective Vaporization Versus Holmium Laser Enucleation For Treatment Of Benign Prostate Hyperplasia In A Small Prostate Volume

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St Marys hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, St Pauls hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, St Pauls hospital, Seoul, Korea

    • Affiliation Department of Urology, College of Medicine, The Catholic University of Korea, St Pauls hospital, Seoul, Korea

    Recovery After Vaporization Therapy

    Rezum for BPH revised

    Vaporization is an outpatient procedure, that allows patients to leave the hospital / surgical center within a few hours after recovery. After the procedure, a urinary catheter will be placed in the bladder to drain urine. This is generally removed after 24 hours. However, some patients may require a catheter for a longer period of time. In general, patients are able to return to normal activities within a short time as directed by their physician.

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    Transurethral Vaporization Of The Prostate / Greenlight

    Laser prostatectomy is a minimally invasive procedure to treat BPH. You may also see it referred to as Greenlight PVP, Transurethral Vaporization of Prostate , or laser prostatectomy. A telescope is placed into the urethra up to the prostate, and your urologist then uses a laser to vaporize prostate tissue that is obstructing flow of urine from the bladder.

    This procedure has fewer side effects than the traditional Transurethral Resection of Prostate and is much more effective than microwave prostate treatments. Laser Prostatectomy is done under general or spinal anesthesia as an outpatient procedure. Most patients keep a foley catheter for less than 24 hours. Other benefits include long-lasting relief of BPH symptoms, the ability to stop BPH medications, and faster return to normal activities.

    Safety And Efficacy In Large Prostates

    Sandhu and colleagues examined the performance of the 80-W KTP laser in large-volume prostatectomy.5 Sixty-four men with BPH having prostate volumes of at least 60 mL who had failed medical therapy were resected with the 80-W KTP laser. Mean preoperative prostate volume was 101 mL, with a mean operative time of 123 minutes. Maximum urinary flow rate increased from 7.9 mL/s to 18.9 mL/s, whereas postvoid residual urine volume decreased from 189 mL to 109 mL at 12 months. International Prostate Symptom Score decreased from 18.4 to 6.7. No patient required a postoperative blood transfusion, nor did any patient display evidence of postoperative hyponatremia. Of the 64 patients, 62 were discharged within 23 hours. This surgical experience demonstrated that the 80-W KTP laser is a safe and effective means for treating men with symptomatic BPH and large prostates.

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    Creating A New Standard Of Care

    The GreenLight Laser Therapy is a procedure that combines the effectiveness of the traditional surgical procedure known as Trans Urethral Resection of the Prostate with fewer side effects.1

    GreenLight uses laser energy to remove enlarged prostate tissue. This results in an open channel for urine flow through, but with less risks of sexual and other side-effects common with TURP. Most patients return home a few short hours after the PVP procedure and can return to normal, non-strenuous activities within days. The GreenLight laser system delivers the ultimate BPH solution free from urinary symptoms, free from compromise, free to go!

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    Bph/enlarged Prostate Program At Chesapeake Urology

    Patent US6986764

    From more conservative, non-surgical measures to innovative minimally invasive procedures, our urologists provide the most advanced care for men living with BPH.

    Laser Vaporization of the Prostate

    Laser Vaporization of the prostate is a technique that uses a special laser to heat and vaporize the prostate tissue that is obstructing part of the urethra.

    In studies comparing the laser technique with the more traditional surgical procedure called Transurethral Resection of the Prostate , GreenLight Laser Therapy improves BPH symptoms and quality of life as effectively, but with fewer side effects.

    Most men are good candidates for laser vaporization therapy, which is an outpatient procedure performed in one of Chesapeake Urologys Summit Ambulatory Surgery Centers. In this procedure, a small fiber is inserted into the urethra through a cystoscope. Laser energy is delivered through the fiber to remove the enlarged prostate tissue, restoring natural urine flow and relieving symptoms of BPH quickly.

    Advantages of Laser Vaporization Therapy:

    • The procedure is minimally invasive and performed on an outpatient basis
    • Most men return home only a few hours after the procedure
    • Quick recovery and return to normal activities
    • Normal urine flow is restored quickly
    • Very few long-term side effects
    • Long-lasting relief from bothersome urinary symptoms

    Risks:

    Some patients may experience minimal side effects from laser vaporization including:

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