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Greenlight Laser TURP (PVP)

Greenlight laser TURP (also called PVP) is a bloodless method for removing benign prostate enlargement (BPH). The advantage over conventional TURP is that the greenlight laser seals the blood vessels more effectively. However, it is a slower procedure and may even take up to 2 hours for large prostates.

How it is done

Safety googles have to been worn to protect the eyes. Under general anaesthesia, a cystoscope is inserted. The specially designed fiber that emits a green laser beam that vapourises the prostate gland to leave a cavity that heals over the next 3 weeks. A catheter is inserted at the end of the surgery but unlike conventional TURP, minimal irrigation fluid is needed. The catheter is removed the next day.

Watch how PVP is done

Hospital stay is just 1 day compared to 3 to 4 days for standard TURP. The other advantage is that anticoagulant medication, such warfarin need not be stopped beforehand. Laser TURP is more expensive because of the added cost of the laser fiber and time taken. Also, the effectiveness for large BPH may not be as good as conventional TURP and the patient may need to undergo a repeat TURP.

Dr Chin doing PVP surgery

Complications include:

  • This is minimal and will clear in a week or two.
  • urinary retention. If so, the catheter will need to be re-inserted and left in for a few days more
  • This is an irritating feeling during urination and due to the raw area within the prostate
  • infection (UTI). This is due to infection of the dead, necrotic prostate tissue

 

Desired outcomes:

  • no secondary bleeding (<3% cases)
  • no UTI
  • no recurrence of BPH needing repeat TURP