Prostate Surgery

What Is GreenLight Laser Therapy?

Most 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 include:

  • Urge incontinence

  • Burning, pain, or discomfort with urination

  • Poor urine stream

  • Difficulty getting started when needing to urinate

  • Dribbling at the end of urination

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;

  • Bleeding

  • 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

  • Water-induced thermotherapy

Invasive surgery

  • Transurethral resection of the prostate

  • Open prostatectomy

  • Transurethral incision of the prostate

  • Cytoplasty

Recovery

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;

  • Resting

  • 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.

Conclusion

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.

Therefore, it is essential to maintain a healthy prostate and reduce prostate inflammation. This can be achieved by eating healthy foods and engaging in physical activity.

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.

Sources

  1. Ajib, K., et al. Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: Five-year experience of safety, efficiency, and functional outcomes. Can Urol Assoc J 2018 Jul;12(7):E318-E324.
  2. Curtis Nickel, J. Benign prostatic hyperplasia: Does prostate size matter? Rev Urol 2003;5 (Suppl 4): S12-S17.
  3. Eken, Alper and Soyupak, Bulent. Safety and efficacy of photoselective vaporization of the prostate using the 180-W GreenLight XPS laser system in patients taking oral anticoagulants. J Int Med Res 2018 Mar;46(3):1230-37.
  4. Elhilali MM, Elkoushy MA. Greenlight laser vaporization versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: evidence from randomized controlled studies. Transl Androl Urol. 2016;5(3):388–392. doi:10.21037/tau.2016.03.09
  5. Nair SM, et al. A review of laser treatment for symptomatic BPH (benign prostatic hyperplasia). Current Urology Reports. 2016;17:45.
  6. Wein AJ, et al., eds. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed May 11, 2016.
  7. Zhang, Zhi-Hua, et al. Management of greenlight laser plus transurethral resection of prostate for elderly men. Medicine (Baltimore) 2018 Aug 97(33):e11862.

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5 Comments Newest

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  1. Paul Limrick

    Had Green Light Proceedure at age 63 Left hospital same day Had full retention at the time
    Lots of bleeding for a week or two them settled
    Some bleeding if I do heavy lifting now 76 take Total Health Get up maybe twice in the night
    No regrets about the proceedure

    • Ben's Natural Health Team

      Hi Paul, thank you for sharing your experience undergoing Green Light Therapy. It is great to hear that your prostate health has improved and that you getting up less when using Total Health. Please kep us updated on your progress and if you have any questions, feel free to get in touch with our team. Wishing you good health, The Ben’s Natural Health Team.

  2. ronald siedler

    I noted what seemed like contradictions in the comparison of advantages vs disadvantages of the green light. The advantages included less catherization, less blood loss, and less time spent in the post op section of the hospital. Yet the opposite of these factors, ie more blood loss, more cath time were listed as the disadvantages of the green laser.
    What is the difference between the HoLEP which I had and the green laser? They seem similar, tho with the HoLEP the laser is based on the element holmium.

  3. Norris Ailshire

    You’re a really valuable internet site; could not make it without ya!|

    • Ben's Natural Health Team

      Thanks for your great feedback Norris!