Greenlight laser prostatectomy allows for bloodless vaporisation of the obstructing prostate tissue. This means that catheterisation times can be significantly reduced and patient stay in hospital minimal. The energy is delivered in a much more controlled fashion. Patients can be done whilst on anticoagulants such as aspirin, warfarin, clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
Greenlight laser prostatectomy (PVP) has been used over a decade. The results show that greenlight laser prostatectomy is functionally equivalent to TURP. The benefit of greenlight laser prostatectomy include a much safer side-effect profile with a lower blood transfusion rate, erectile dysfunction and urinary incontinence. On average patients after TURP stay in hospital for 2 to 3 days with a catheter (tube through the penis into the bladder) in situ. This is usually due to ongoing bleeding and the need for irrigation (washout) of the bladder.
The procedure is usually done under a general anaesthetic, which means that you will not feel any pain during the procedure. The procedure is completed using a thinner telescope, the thickness of a normal pencil. This telescope is passed through the eye of the penis and allows vision of the tissue being removed. A laser fibre is inserted through the cystoscope and the prostate tissue vaporised. Only the inner portion of the prostate is removed. That is, the prostate gland is NOT entirely removed. A catheter is placed at the end of the procedure. Some patients are able to go home the same day after an early removal of catheter. Others will have the catheter removed the following morning and after passing a trial of void (i.e. urinating satisfactorily without a catheter) are able to go home.
St Vincent's Hospital Lismore was the 4th hospital and 1st non-metropolitan hospital to acquire a greenlight laser. The outcomes have been excellent and St Vincent's has become a training centre for greenlight laser prostatectomy.