Photoselective vaporization of the prostate is a minimally invasive procedure that uses a laser to clear excess prostate tissue associated with an enlarged prostate – also known as Benign Prostatic Hyperplasia or BPH. By clearing excess tissue, this procedure restores urine flow, and provides welcome relief from BPH symptoms.
It is used to treat benign prostatic hyperplasia (BPH), a non-cancerous growth or enlargement of the prostate gland. PVP is recommended for patients who has urination symptoms resulting from benign prostatic enlargement such as inability to urinate; bleeding through the urethra; kidney damage caused by urine backing up; frequent urinary tract infections; or stones in the bladder. Symptoms that people who may have BPH include: -Poor urination -Frequency of urination -Night time urination more than two times/night
PVP is performed under local, spinal or general anesthesia and takes between 20 and 50 minutes. A very large prostate may take longer time. During the procedure, the surgeon will use tube called an endoscope to deliver the laser to the prostate vaporizing any excess tissue. Some patients will be required to be catheterized for up to 24 hours after surgery.
Several days before surgery, your doctor might recommend that you stop taking medications that increase your risk of bleeding, such as: -Blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix) -Nonprescription pain relievers such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) -You are likely to be prescribed an antibiotic to prevent urinary tract infection.
Vaporization is an outpatient procedure, that allows patients to leave the hospital / surgical center within a few hours after recovery. After the procedure, a urinary catheter will be placed in the bladder to drain urine. This is generally removed after 24 hours. However, some patients may require a catheter for a longer period of time. In general, patients are able to return to normal activities within a short time – as directed by their physician.
Complications are infrequent and usually minor. There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include the possibility of:
-Small amount of blood in urine
-Mild irritation or urinary frequency for short period of time
-Emptying of semen into the bladder instead of out of the urethra (called retrograde ejaculation, or ‘dry’ orgasm)
-Some patients may experience bleeding and blood in the urine for several weeks after surgery. Risks can be reduced by following the surgeon's instructions before and after surgery.
Who are the best candidates for this procedure?
The best candidates for Photoselective Vaporization of Prostate (PVP) are men with moderate to severe symptoms (i.e., bladder obstruction) caused by prostate enlargement either or not responded to proactive medical therapies. Patients with prostates of a combined volume of more than approximately 250cm3 may not be candidates for PVP or other transurethral procedures. More invasive surgical techniques may be required. The urologist will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient.
What are other types of laser surgery for the prostate?
1. Holmium laser ablation of the prostate (HoLAP). This procedure is similar to PVP but uses a different type of laser.
2. Holmium laser enucleation of the prostate (HoLEP). A laser is used to cut and remove the excess tissue that is blocking the urethra. Another instrument is then used to cut the prostate tissue into small pieces that are easily removed. HoLEP can be an option for men who have a severely enlarged prostate.