Please have any pathology or radiology tests competed if requested during your appointment. Take your normal medications unless told otherwise by Dr Murray or the anaesthetist. Please inform Dr Murray if you are taking any blood thinners. The procedure requires a general or spinal anaesthetic therefore you will need to fast for six hours prior to the procedure. Please ensure someone has been arranged to drive you home when you are discharged from hospital.
After administration of the anaesthetic the telescope (a rigid cystoscope) is inserted into the urethra and advanced to the prostate and bladder. The internal lining of the prostate and bladder is examined prior to commencing laser vaporization. The laser fiber is inserted through the cystoscope and the laser beam pointed at the prostate tissue. The laser vaporizes the tissue and coagulates blood vessels eliminating bleeding. The procedure takes 30 to 90 minutes depending on the size of the prostate. A catheter is inserted at the end of the procedure.
A period of time is required in the recovery room while the anaesthetic wears off. It is necessary to ensure you are comfortable and the catheter is draining prior to being transferred to the ward. On the ward you may eat and drink as normal. You will be encouraged to mobilize. You will wear compression stocking and be administered a blood thinner in order to reduce the risk of blood clots forming in the legs (DVT).
At 0600 the morning after your procedures a nurse will remove your catheter and encourage you to drink fluids. The nurse will measure the volume of urine you pass and scan your bladder to assess how much urine is left inside. The nurse will update Dr Murray by phone and if you are emptying your bladder satisfactorily you will be discharged (usually around midday). You will go home on a preventative oral antibiotic for seven days.
The prostate needs to heal after the procedure and this may take up to eight weeks. During this time you should expect: a stinging or burning sensation when you pass urine, the need to pass urine frequently, an urgent need to urinate and intermittent bleeding in the urine. Taking Ural sachets and over the counter pain medication often helps. In cases of heavy bleeding with clots and an inability to pass urine you may require re-insertion of a urinary catheter.
A follow up appointment with Dr Murray will be made for six to eight weeks post procedure.
There are some important side effects, risks and complication of Greenlight PVP you should be aware of these include but are not limited to:
1. Haematuria (blood in the urine)
2. Dysuria (stinging or burning sensation when passing urine)
3. Urinary tract infection (approx 5%)
4. Sepsis (rare)
5. Reduced or absent ejaculation (common approx. 70%)
6. Ongoing bothersome urinary symptoms and need for further treatments
7. Need for repeat procedure (uncommon 10% over 10 years)
8. Urinary incontinence (uncommon and if occurs often temporary)
9. Urethral stricture formation (uncommon)
10. Bladder perforation (rare)
