Green light laser for prostate, laser surgery for prostate
In their lifetimes, roughly half of all men over 60 will develop an enlarged prostate, a condition that leads to difficulties with urination. Now, the Department of Urology is using new laser technology to treat this condition with less risk and a shorter hospital stay, compared to traditional surgical methods.
Enlarged prostate, also known as benign prostatic hyperplasia (BPH), occurs when excess prostate tissue develops and puts pressure on the urethra, which carries urine from the bladder. Like a clamp, the excess tissue impedes the flow of urine, resulting in weak, frequent urination and other problems.
PAMF physicians previously treated BPH with a surgical procedure called transurethral resection of the prostate (TURP), in which excess prostate tissue is removed by the surgeon using standard electrical current. The new GreenLight PVP (photoselective vaporization of the prostate) system uses a special, patented green-light laser ­ a more effective wavelength than in other lasers ­ to remove the excess tissue. The procedure is minimally invasive: a laser fiber is threaded into
the urethra to deliver the green-light energy, then removed.
GreenLight treatment appears to have the same success rate as standard TURP in alleviating symptoms, with less risk of bleeding and a shorter hospital stay, said Daniel Yao, M.D., of the PAMF Department of Urology (see box).
"The vast majority of patients have great improvement in their urinary stream and other symptoms after GreenLight laser treatment. Studies of the GreenLight procedure, which provide about five years of data, show that symptom improvements last at least that long," Dr. Yao said. "At this point, we feel that it should be considered for any patient who is a candidate for surgery, and we have performed very few standard TURPs in the past 10 months."
Dr. Yao noted that patients may experience some urinary urgency for one to two weeks after the surgery, which resolves as the urethra heals.
All PAMF urologists are certified to use the GreenLight laser. Procedures are performed at Stanford University Hospital and involve either general or spinal anesthesia.
For more information about the GreenLight laser procedure, visit the manufacturer's Web site at www.laserscope.com.

Comparing Procedures
Standard TURP	GreenLight PVP
Significant risk of bleeding during and after surgery Hospital stay of at least one to two days Catheter used for at least one to two days Slight risk of impotence, incontinence and other long-term problems	Laser seals off blood vessels, so much less risk of bleeding Hospital stay of a few hours or overnight Catheter used briefly or not at all Lower risk of long-term problems