Some men with an enlarged prostate gland (BPH) require surgery to treat the associated symptoms.
Your doctor will help you determine the best treatment option depending on your symptoms and health.
GreenLight Laser therapy is a minimally invasive surgery developed to help reduce the complications associated with invasive methods.
It has similar efficacy to prostate TURP, but with lower rates of complications and patient recovery time. However, you may require reoperation if your BPH symptoms persist.
This article will discuss the effectiveness of GreenLight Laser for the treatment of BPH.
What is Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia refers to an enlargement of the prostate. In many cases, the condition is referred to as an enlarged prostate.
The swelling that occurs in the prostate gland can lead to several problems and discomforting symptoms.
Symptoms of BPH
- Urge incontinence
- Burning, pain, or discomfort with urination
- Poor urine stream
- Difficulty getting started when needing to urinate
- Dribbling at the end of urination
- Pain during urination or ejaculation
- Blood in the urine (hematuria)
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What is GreenLight Therapy
Laser Photoselective Vaporization of the Prostate also called GreenLight therapy, is a new minimally invasive surgery to treat benign prostatic hyperplasia (BPH).
Prostate enlargement blocks the urethra and causes urinary complications. GreenLight technology involves using high-powered laser light to vaporize excess prostate cells. The technique is quick and accurate, reducing the damage to surrounding tissues.
Generally, minimally invasive treatments for BPH require less recovery time. You have a reduced risk of developing urinary and sexual side effects, such as erectile dysfunction, after laser surgery to treat BPH compared to TRUP.
The surgeon directs laser energy to the prostate through a fiber tube inserted through a small cut on your body.
The intense pulses of light emitted by the fiber pass through the local blood vessels, increasing the temperature of the blood. This high temperature causes thermal vaporization of the nearby prostate cells.
What are the benefits of GreenLight Therapy?
Because of minimum tissue damage, GreenLight therapy causes fewer wounds and has reduced healing time.
Like many minimally invasive prostate procedures, there is reduced;
- Post-operative sexual dysfunction
- Time to resuming normal activities
- Hospital stays
What are the Risks of GreenLight Therapy?
The Greenlight technique uses an energy beam delivered through a thin laser fiber to safely and precisely vaporize surface tissue.
Short-term studies show that it has fewer side-effects compared to TURP. However, there are risks associated with any surgical procedure.
There is a risk of reoperation after Greenlight therapy (Thomas et al., 2016). It can cause bladder neck contracture that requires surgical intervention to correct.
Unfortunately, there is a lack of long-term studies evaluating its safety beyond 10-years after surgery. Further safety and efficacy studies are needed to address the cause of reoperation adequately.
GreenLight Therapy vs. TURP
GreenLight laser therapy is considered a viable alternative to the invasive transurethral resection of the prostate (TURP).
A randomized clinical trial compared the GreenLight laser system with TURP 12-months after surgery. The study showed that patients treated by GreenLight laser therapy had similar symptom scores and complications compared to TRUP.
Expectedly, GreenLight laser surgery was associated with
- Improved time to stable disease
- Length of hospitalization
- The need for immediate surgical intervention compared to TURP.
In addition to efficiency, the simplicity of GreenLight therapy makes it beneficial to both patients and surgeons.
It is associated with immediate symptom relief with fewer short-term side effects compared to other BPH treatment methods. However, this is a new technique with poorly characterized long-term side effects. The results of smaller trials with extend follow-up suggest that patients maintain their improved outcomes.
Alternatives to GreenLight Therapy
Depending on your symptoms, three treatment options are available to treat BPH.
You may be offered watchful waiting, drug therapy, or surgical interventions (inversive and minimally invasive techniques).
TRUP is the standard of care but can increase your risk of developing impaired sexual function as well as urinary tract infection.
Minimally invasive surgery
- Transurethral microwave thermotherapy
- Transurethral electro vaporization
- Transurethral resection of the prostate
- Open prostatectomy
- Transurethral incision of the prostate
You might have surgery on an outpatient basis or need to be admitted to the hospital. Your doctor will discuss the exact setup, depending on your symptoms.
GreenLight therapy will cause some level of swelling that may block urine flow. Thus, you are likely to have a catheter in place for up to three days post-surgery.
You might notice blood in your urine, feel an urgent or frequent urge to urinate or develop urinary incontinence. However, these symptoms will improve with one week. You are at increased risk of infections if you have a urinary catheter inserted for longer.
Expect to wait for more than two weeks before you achieve noticeable improvements in your initial lower urinary tact symptoms.
You can improve your recovery by;
- Performing mild exercise
- Adequate fluid intake
- Strict adherence to your discharge information
- Sex post-operation
Avoid sexual activity for four weeks of post-GreenLight therapy. You may experience sexual complications such as retrograde ejaculation but will retain usual sexual pleasure. It is better to resume normal sexual activities as soon as you can.
Green Light laser therapy is a useful minimally invasive way to treat symptoms of BPH. However, it leaves most of the prostate gland untouched, making it possible for BPH reoccur or for you to develop other prostate conditions.
Prior to undergoing any surgery, speak with your urologist about the possible side effects. The issue with the majority of procedures is that they damage the prostate. Therefore they can cause short or even long-term consequences.