Laser PVP Surgery - An Overview

Introduction:

An enlarged prostate can be treated minimally invasively by laser PVP surgery. During the process, the prostate is photo-selectively vaporized (PVP) using a laser. A tube with an imaging device (cystoscope) is introduced into the penis during laser PVP surgery. Using a cystoscope, a surgeon uses a laser to burn away extra tissue that is obstructing the prostate's ability to flow urine. The tissue is not sliced or scraped during laser PVP surgery, in contrast to traditional prostate surgery. As less blood is typically lost as a result, patients who take blood thinners or have blood-clotting disorders may find laser PVP surgery to be a viable alternative.

What Is Laser PVP Surgery?

PVP uses a high-power green light laser that is patented to eliminate extra prostate tissue. In an almost bloodless operation, the laser energy rapidly vaporizes and accurately eliminates the swollen prostate tissue. This makes it possible to treat patients on blood thinner medication, such as Warfarin or Aspirin. In addition, it may treat particularly big prostate glands that often require an open surgical approach and are not receptive to other contemporary techniques.

PVP dramatically improves natural urine flow while quickly relieving urological problems by removing excessive tissue. In many circumstances, patients are discharged without needing a catheter and in less than twenty-four hours. There are few adverse effects and a quick, easy recovery period.

What Takes Place In Reality?

After administering anesthesia, the physician uses a cystoscope—a device that allows for the examination of the bladder and prostate—to inject a thin fiber into the urethra. The green laser energy delivered by the fiber accurately and swiftly vaporizes the enlarged prostate tissue. The doctor may safely view and control the treatment region and customize it to fit unique anatomy and demands.

The tissue being vaporized and eliminated forms an open channel. Urinary symptoms are promptly eased, and natural urine flow is promptly restored. Over five years, clinical investigations have demonstrated PVP laser therapy's safety, effectiveness, and durability. After thousands of successful PVP procedures, Massachusetts General Hospital is now providing this ground-breaking treatment to men with enlarged prostates.

What Are the Benefits of Laser PVP?

• Less suffering and blood loss.

• Patients can resume their regular activities in two to three days. Depending on the circumstances, high-impact activities like weightlifting and aerobics can be resumed in four to six weeks.

• Lower likelihood of complications.

• Same outcome as usual treatment.

• Constraints With Laser PVP therapy.

• Since the tissue biopsy was vaporized, it is unavailable for histological investigation.

• Urine flow significantly improves following an almost bloodless operation.

• Most patients are catheter-free in less than 24 hours, often immediately following the operation.

• Within two to three days, patients can resume their regular daily activities.

Who Should Use Laser PVP?

• Those who are elderly or have medical ailments need to take blood thinners constantly.

• Patients must heal quickly to resume their regular activities.

What Should Be Anticipated From the Procedure?

After the procedure, a catheter—a small tube that empties urine into a bag—is placed into the bladder. Occasionally, the catheter might be attached to a device that cleans the bladder of blood and blood clots, called bladder irrigation. The catheter will be removed, and, provided enough pee is passed, the patient will be allowed to return home after there is no longer a chance of clots, which normally happens within one day.

• Bladder Spasms: The catheter is to blame. If these are severe, sometimes medicine is needed. Urine burning is a typical occurrence that might linger for several weeks. Ural sachets can be taken to aid with this.

• Debris Passing: For a few weeks during the healing process, one may observe little floating "dead bits" of the prostate in urine.

• Bleeding: This should stop after two to four weeks and normally lessens with time. However, it can be sporadic unless there is a medical reason not to; oral fluid consumption should be raised to two to three liters per day. If urine is clear, it can reduce fluid intake. Some post-procedural symptoms (such as urgency and frequency) may persist for several months, primarily as the bladder adjusts to not having the blockage caused by the prostate. These occasionally may worsen than were before the procedure.

• Retrograde Ejaculation: Following a greenlight laser, the majority of males experience erections and orgasms. However, because the prostatic tissue and bladder neck are open, they might not ejaculate. As a result, the semen gathers in the bladder and is released at subsequent urination. Retrograde ejaculation carries no long-term dangers.

How About Diet?

• Eight to ten glasses or two to three liters of fluids should be consumed unless one is on a fluid restriction because of cardiac disease.

• Avoid acidic beverages like orange or cranberry juice, which can exacerbate bladder irritation, burning, and stinging.

• Consume a fiber-rich diet to avoid strain when going to the bathroom.

How About Activity and Exercise?

Avoid, unless the doctor instructs otherwise, for two weeks following surgery:

• Demanding exercise.

• Hard lifting (such as when picking up kids or grocery shopping).

• Engaging in sexual activities.

• Playing sports.

• Walking is not restricted.

How Do Medications Fit In?

• One can start taking prescriptions as usual again.

• If the doctor discontinues the blood thinner, he will advise when to start again.

• One can take one to two Paracetamol for pain and discomfort every four to six hours (but no more than eight a day).

• Ural sachets, a urine alkalizer that may be found in pharmacies and supermarkets, lessen urine acidity and ease burning and stinging sensations.

Conclusion:

According to the data from an international group, approximately one percent of men will require a revision operation after laser vaporization, which has a very high success rate of over 95 percent in most series. The rate of reoperation also varies depending on the amount of tissue removed. Greenlight PVP's minimally invasive nature does allow for quicker recovery to normal physical activity and sexual activity (after two weeks).