The GreenLight PVP™ Procedure at the Urology Center of Florida

Patient Selection

Suitable candidates for GreenLight™ photoselective vaporization of the prostate (PVP) include any patient with clinical benign prostatic hyperplasia (BPH), American Urological Association (AUA) symptom score greater than 13, flow rate less than 15 mL/sec and postvoid residual urine greater than 50 mL.

Prostate size or concomitant anticoagulant therapy are not contraindications to the PVP.  Similarly, patients who have undergone prior transurethral resection of the prostate (TURP) or who have failed heat or thermal therapies may safely undergo PVP.

Pre-Procedure Preparation

Routine pre-operative testing is performed which includes: History and Physical Examination, Electrocardiogram, Chest X-Ray, Complete Blood Count, Coagulation Profile, Comprehensive Metabolic Panel, and Urinalysis.

The night before the procedure, patients may eat and drink as usual. However, if the procedure is scheduled before noon the following morning, patients should not take anything by mouth after 12:00 midnight the night before. If the procedure is scheduled in the afternoon, patients may be allowed to have a clear liquid breakfast.

Patients should plan to arrive two hours prior to their treatment and plan to spend some time after the procedure to recover from anesthesia prior to being discharged. 

Patients may not drive or operate dangerous equipment for 48 hours after the procedure.

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The GreenLight™ PVP Procedure

Once the patient is anesthetized, a thin fiber is inserted into the urethra through a cystoscope, an instrument that allows examination of the bladder and prostate. The fiber delivers green laser energy that quickly vaporizes and precisely removes enlarged prostate tissue. The doctor is able to safely view and control the treatment area, tailoring it to the patient’s individual anatomy and needs.

Because the tissue is vaporized and removed, a wide-open channel is created. Natural urine flow is immediately restored and urinary symptoms are relieved quickly.

Potential Risks and Complications

There are a few risks with the PVP procedure. Most patients report a very high level of satisfaction. Patients may experience slight burning during urination and/or a small amount of blood in the urine for a couple of weeks. Some men may experience more severe symptoms, which can be treated with medication. Retrograde ejaculation or "dry climax" may occur.

What to Expect After the Procedure

Discharge Home: The PVP is performed in an ambulatory surgery center and patients are released a few hours after the procedure.

Signs and Symptoms: Urinary urgency and mild burning are common and should subside in a few weeks. Some patients may experience a small amount of bleeding with urination which may be accompanied with small blood clots. This is normal, and should be relieved by increasing fluid intake.

Urinary Catheter: You may need a catheter to drain your bladder, depending upon how much swelling you experience after the procedure. Generally, catheters are removed within 24 hours.
 
Diet and Fluid Intake: Avoid coffee, tea, carbonated beverages, alcoholic beverages, citrus juices, spicy foods and smoking for the first 3 days following surgery. Increase your intake of fluids, particularly water. Typically, 24 to 48 ounces over your usual daily fluid intake is recommended. Limit fluids after 6 pm.

Bowels: Do not strain when having a bowel movement. Expect irregular bowel habits until fully recovered. Increase fiber in your diet. You may need a stool softener or laxative during the first two weeks of your recovery.

Bathing:  You may shower as usual.  Urinary catheters, if required, should not be submerged below water.

Activity: Rest for the first 48 hours after the procedure. Do not drive or operate dangerous equipment for 48 hours following anesthesia. You may be able to resume non-strenuous activities after 48 hours unless otherwise directed by your physician. Avoid strenuous exercise, heavy lifting, bike riding, and yard work for two weeks, as the vibrations and movement may cause bleeding. No sexual activity for two weeks after the procedure.

Medications: You can resume your usual medications after the procedure. Do not take blood thinners or aspirin products for one week or as directed by your physician.

When to Call Your Doctor

Please call the office immediately if any of the following symptoms appear: Bright red bleeding in urine with a heavy blood clot; Fever over 101º F (38°C); Inability to urinate for more than 4 hours; Feeling of bladder fullness that does not go away after urinating; or Severe pain at any time.

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