Green Light Laser (GLL)

GreenLight Laser therapy is performed with a small fibre inserted into the urethra via a cystoscope. The fibre/laser provides so much energy that the prostate tissue is vaporised (turned into gas bubbles). This process is continued until the enlarged prostate tissue has been removed. This produces excellent results.

The GreenLight Laser usually needs less hospital time than traditional prostate surgery and involves less bleeding. The reduction in blood loss is so significant that we are very actively recommending the Green Light Laser for our patients who are on anticoagulants such as aspirin, warfarin, Plavix or Iscover and who would be at risk if they stopped.

The major advantages of the Green Light Laser treatment is that it is less invasive, with less blood loss, usually shorter hospital stay and faster return to work. It is particularly useful for the more elderly man with other medical problems.

We use the GreenLight Laser at Warringal Private Hospital and Northpark Private Hospital where there is usually no extra charge to health fund rebates.

Note: The alternative to GreenLight Laser therapy treatment is TURP.

What are the advantages of GreenLight Laser?

  • Rapid urine flow improvement
  • Quick return to normal activities
  • Virtually bloodless procedure
  • A definitive, long lasting treatment
  • Less than 1% reported cases of erectile dysfunction
  • Short to possibly no catheterization (less than 24 hours in most cases)

What happens during the GreenLight Laser Procedure?

First the Urologist will perform an evaluation to see if you are a candidate for this treatment. Then, on the day of your procedure, you will come to the day surgery. You should make arrangements to have someone drive you home since this is a surgical procedure. In some cases, you may be required to stay overnight. The surgeon will determine this.

Each patient is different – therefore treatment procedures may vary. Below is a description of the procedure and what to expect.

  • Before treatment, your Urologist may give you a medication to help you relax during the procedure. Other medications may be given to you to avoid infections.
  • You will be brought into the operating theatre and moved onto a trolley where you will lie on your back. You will be given a general anaesthetic that will allow you to sleep through the entire procedure. Occasionally, other types of anaesthesia may be used such as a spinal anaesthetic.
  • Once you are asleep or the anaesthesia block takes effect, your urologist will insert a cystoscope through the urethra.
  • The laser fibre is introduced through the cystoscope and advanced into the urethra at the location of the prostate.
  • The urologist systemically vaporizes the enlarged prostate tissue until the obstruction is removed.
  • At the end of the procedure the urologist will place a temporary catheter to let urine drain from your bladder.

What happens after GreenLight Laser procedure?

If a catheter was placed in your bladder at the end of the procedure, it will typically be removed in the morning. Patients usually pass their urine promptly following catheter removal. The nurse will check to ensure the bladder is empty using the bladder scanner and if satisfactory, they will be discharged later that day. If, however, there is ongoing bleeding or the patient is not continent, then they will not be discharged.

Patients with compromised bladder function or those who have required prolonged catheterization as a result of severe urinary symptoms may require a catheter for a longer period of time.

You must make arrangements to have someone drive you home.

Most patients experience very rapid relief of symptoms and a dramatic improvement in urine flow. This typically occurs within 24 hours of the procedure. However, medical history, health condition and other factors can influence treatment recovery.

At home

Discomfort and urgency

You will usually go home the day the catheter is removed. You may experience mild discomfort such as slight burning during urination and small amounts of blood in you urine for a week or so. Also, depending on the condition of your bladder, you may experience greater frequency and urge to urinate. Some patients develop quite marked discomfort passing urine. This usually comes on a few weeks after the operation. It may be distressing, but it resolves over time as the bladder adjusts to emptying without obstruction. Contact us if this is bothering you.

Bleeding

You may notice some bleeding for a few weeks. This is much more likely to be an issue for those patients on strong blood-thinners. It’s important you drink adequate fluids following your procedure to keep your urine clear.

Activity

It is usually wise not to drive a car for a couple of weeks. Do not indulge in any strenuous activity for four weeks. Avoid heavy lifting, gardening and golf. Refrain from horse riding, motorcycle or bicycle riding. You may return to work after 1 week unless you have a heavy manual job, where it is wise to wait an extra week.

Bowels

It is important to keep the bowels soft and regular. A high fibre diet incorporating Bran and well as well as increased fluids often helps.

Continence
Most patients have excellent control of their bladder when they leave hospital. There are a few who still have some problems controlling the flow of urine. This is usually due to damage already done to the bladder by the prostatic obstruction. With time, all such cases improve. Permanent loss of continence is a very rare complication of GreenLight Laser therapy.

Some men who have presented with retention may have trouble passing urine or emptying their bladders completely after the operation. This occurs because the bladder has been overstretched and becomes weak. These patients may require a period of indwelling or intermittent catheterization at home while their bladders recover.

Sexual function

Many men are concerned that a prostate operation will end their sex lives. However, with today’s techniques this is very uncommon. The only difference is that after the operation, there may be no emission with ejaculation (nothing comes out). This is due to the removal of the bladder neck. This means semen passes backwards into the bladder during ejaculation and you may note that the urine you pass after intercourse appears a little cloudy. This is nothing to worry about, as the fluid will do no harm. The ability to maintain an erection is nearly always retained and sexual intercourse can be resumed a few weeks after surgery.

Follow up appointment

You will return to the rooms approximately 4 weeks following your procedure to see your doctor.

You are advised to call the rooms if you experience any of the following symptoms:

  • Fever
  • Cloudy or offensive urine
  • Difficulty/inability to pass urine
  • Increased/worsening of bleeding and passing of clots
  • Slow stream
  • Increased urgency (the need to pass urine with little warning)
  • Increased frequency (the need to pass urine more often)