Benign Prostatic Hyperplasia (BPH) can cause severe trouble in urinating with age. About 50% of men will experience a radical change in urinating during their lives because of this benign growth.
Surgical treatment of benign prostatic hyperplasia (BPH), a treatment method being used for the past 20 years, is based on transurethral resection of the prostate (TURP).
The treatment is undergoing revolution in terms of its nature with the advent of laser technology. In fact, the non-negligible percentage of post-operative complications related to TURP (persistent microhematuria, post-TURP syndrome, anemia), has resulted in the industry’s ever increasing interest in search of the ideal method for resolving the obstruction of prostatic hyperplasia, a system whose main features should be minimal invasiveness, absence in the problems of intraoperative reabsorption of liquids, absence of bleeding, possibility of the total removal of the prostatic adenoma, shorter duration of stay in the hospital and the reproducibility of the results. The application of the laser technology to prostate surgery is itself a sign of significant improvement in the ideal surgical approach used in the last decade.
The new standard for the surgical treatment of Benign Prostatic Hyperplasia is the photoselective vaporization of the prostate using the GREEN LASER, more commonly called “GreenLight laser prostatectomy”. It is a minimally invasive procedure that results in significant improvements in the urinary symptoms.
A thin fiber is inserted into the urethra through a cystoscope, an instrument that allows the doctor to examine the bladder and the prostate. The fiber delivers green laser energy that quickly evaporates and removes the prostate tissue.
The urologist is able to view and check safely the area of treatment, by adapting to one’s anatomy and needs. Since the prostate tissue is vaporized and removed, it creates a wide channel: as a result, the flow of urine is immediately restored and all the urinary symptoms should be treated.
The green laser light used in the vaporization has a wavelength that gets easily absorbed by the hemoglobin present in the red blood cells. Because of this, the tissue which has blood in it (such as the prostate) gets selectively vaporized. Once the capsule of the prostate is reached, vaporization ceases completing the procedure: by being fibrous, the prostatic capsule has no hemoglobin and is therefore protected from the laser.
The ADVANTAGE of this procedure in comparison to TURP is that, in this procedure, the prostate tissue gets vaporized selectively rather than cut-off. When the prostate tissue gets cut off in the TURP procedure, the prostate bleeds abundantly while, during the photoselective vaporization, this tissue does not bleed at all.
The GreenLight laser exploits the capability of the tissue vaporization by lithium triborate crystals with the consequent advantage of an operation which is mini-invasive, bloodless, without any possibility to cause problems in the resorption of fluid and requires a short stay in the hospital.
The advantages of GREENLIGHT XPS 180 watt manufactured by American Medical Systems, Inc. are numerous.
- With the use of intraoperative saline, the BPH treatment has become more successful (risk of resorption of liquid is minimal or absent).
- Because of the great coagulation capacity of GREENLIGHT XPS that allows the removal of the urinary catheter and the secretion of the discharge to flow in the first or the second day, the number of days required for hospitalization for availing the treatment has reduced significantly.
- Absence of intra and postoperative bleeding complications which can result into re-operations.
- Possibility of treating anticoagulated patients, without suspension of the same (non-insignificant advantage in an era of an ever increasing use of antiplatelet therapies related to cardiovascular events).
- Elimination of problems connected to blood transfusions.
- Possibility of the treatment of the patients with pacemakers, since no electric energy is used.
Quicker functional recovery of the patient.
The results are equivalent to those of TURP with fewer side effects and complications.
- Rapid and significant improvement in urinary flow.
- Treatment given to patients with varying severity in symptoms.
- Further studies support the use of GreenLight on the large sized glands, on anticoagulant and high-risk patients.
- One Day Surgery Procedure (one night of hospitalization). Much lower risk compared to TURP; no significant risk of TURP syndrome.
Much lower risk compared to TURP; no significant risk of TURP syndrome.
- Catheterization of the average duration of 72 hours.
- Mild irritative symptoms that last for short duration only.
- Quick resume of normal activities.
The safety and effectiveness of photoselective vaporization with GREEN LASER has seeped in a revolution in the traditional treatment of Benign Prostatic Hyperplasia (BPH).