Scheduling Appointments For Enlarged Prostate Treatment At New York Urology Specialists
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Dr. Alex Shteynshlyuger is a board-certified urologist and specialist in the treatment of urinary problems in men. He is one of the few urologists who offers a full range of treatment options for BPH . He specializes in all aspects of care for men with an enlarged prostate and urinary problems, including frequent urination at night, difficulty emptying the bladder, urinary urgency, and incontinence. He has successfully treated thousands of men with urinary problems, including urinary retention, painful urination, and frequent urination.
How Greenlight Laser Prostatectomy Works
GreenLight laser prostatectomy is a procedure in which the excess prostate tissue is removed to relieve constriction of the urethra, allowing easy passage of urine.
During the procedure, which is also known as photoselective vaporization of the prostate , the patient is sedated. The physician passes a cystoscope, a thin tube with a very small camera, into the urethra, the vessel that carries urine from the bladder through the penis and out of the body. A small fiber that transmits laser energy is then passed through the cystoscope.
The laser is used to vaporize excess prostate tissue that is limiting the flow of urine. Most patients can expect very rapid relief of their BPH symptoms, often within 24 hours of GreenLight Laser prostatectomy.
For most men, GreenLight laser prostatectomy is an outpatient procedure, allowing them to return home the same day.
What Are The Risks
All surgical treatments have inherent and associated risks. The GreenLight Laser System is intended for the removal of soft tissue, including vaporization of the prostate for benign prostatic hyperplasia . Potential risks include irritative symptoms, bleeding, retrograde ejaculation and urinary tract infection. You should talk with your doctor about benefits and risks before moving forward with any treatment option.
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Recovery After Vaporization Therapy
Vaporization is an outpatient procedure, that allows patients to leave the hospital / surgical center within a few hours after recovery. After the procedure, a urinary catheter will be placed in the bladder to drain urine. This is generally removed after 24 hours. However, some patients may require a catheter for a longer period of time. In general, patients are able to return to normal activities within a short time as directed by their physician.
Green Light Laser Prostate Surgery Is A Big Boon
Prostate enlargement is a deadly infection experienced by most of the men that brings discomfort in their life. It is caused due to growth of prostate gland due to which urethra is compressed.
As such the follow passage for urine is obstructed and this results in increased bothersome urinary symptoms like irritation, strained, slow, discontinuous and frequent urine. Among many treatments to cure this infection, green light laser therapy is one of the best treatments for this infection as it involves the use of modern technology of lasers.
Since long this treatment has set of new standard care for treating enlarged prostate symbols. You might have heard about the surgery with the name PVP, which stands for photoselective vaporization of the prostate. Green light laser therapy has received FDA clearance in May 2001.
Basically laser surgery uses high energy lasers to destroy prostate tissue. Following procedure is followed in green light laser surgery. The patient is first given general or spinal anesthesia. The doctor then passes the thin laser fiber through the passage called urethra into the prostate using cytoscope, cytoscope is a camera that allows doctor to examine bladder and prostate, and delivers bursts of energy. Each burst lasts for 30 to 60 seconds. The high energy of lasers destroys prostate tissue by vaporizing them and prostates are thus removed.
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Greenlight Laser Therapy Animation
Although it is a benign condition that becomes more common as men age, BPH can be distressing. As the prostate gland enlarges, it squeezes the urethra, the tunnel that carries urine from the bladder out through the penis.
Signs of BPH are:
- urgent or frequent need to urinate during the day and at night
- a slow or weak urinary stream
- difficulty completely emptying the bladder
- difficulty or delay in starting urination
- a urinary stream that starts and stops
When medical management of BPH symptoms is ineffective or the side effects of medications cannot be tolerated, men may choose a surgical procedure to correct the problem.
Evolution Of Intraoperative Parameters Over The Training Period
Control charts for total and step-specific energy delivered on the prostate during aPVP are showed in Supplementary Figure 1. The punctual distribution depicted a trend toward lower amounts of energy delivered for increasing surgeon’s experience.
During the training period, a progressive linear drop in energy delivered on the prostate was observed. At CUSUM analisys the surgeon’s proficiency reached a plateau after the 40th case, as reported in Figure 2. The same analysis stratified by the steps of the procedure showed that the plateau was reached after 37 cases for step 1, 28 cases for step 2, 41 cases for step 3, 39 cases for step 4, and 42 cases for step 5 . The analysis of the distribution of the total energy delivered on the prostatic tissue over the consecutive cases confirmed a progressive decrease in the energy delivered over the training period . A similar trend was noted for the overall operative time, which progressively decreased over the training period .
Figure 2. Cumulative summation analysis of total energy per ml of prostate volume during the training process.
Figure 3. Linear regression: Total energy adopted/number of procedures and total operative time/number of procedures during the training process.
Surgeon’s experience and preoperative prostate volume were found to be the only indepenedent predictors of the overall operative time at multivariable analysis .
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Data Extraction And Statistical Analysis
Preoperative parameters were extracted together with intraoperative data including operation times, changes in haemoglobin and transfusion rates. Postoperative data including length of hospitalisation, duration of catheterisation and treatment-related complications were also analysed. Functional results including IPSS, Qmax, PVR, QoL and IIEF were assessed at 3, 6, 12, 24, 36 and 60 months after surgery.
Mean difference was used to assess continuous parameters. Authors were contacted when data were expressed as medians with corresponding range values. Otherwise, the statistical formula elaborated by Hozo et al was implemented to back-calculate means and SD in accordance with the recommended methods described in the Cochrane Handbook for Systematic Reviews.
Results were expressed as risk ratios with corresponding 95% CI for dichotomous variables. I2 was utilised to assess heterogeneity across studies. An I2< 50% is generally considered an acceptable level of heterogeneity therefore a fixed effect model was applied. In instances where the I2> 50%a random-effects model was applied as is the standard procedure for higher levels of heterogeneity. Pooled effects were synthesised using Z test and a p value < 0.05 was set at the threshold for statistical significance.
Enlarged Prostate Laser Surgery: Recovery Side Effects And Natural Treatment
Prostate enlargement is a common feature in males over fifty years of age. Prostate is a gland at the base of the urinary bladder and around the urethra. It is in a size of large chest-nut. Most common enlargement of prostate is benign enlargement of prostate. It is non-cancerous and usually causes obstruction of urine outflow, increase in frequency of urination especially in night and dull pain below umbilical region. Cancerous enlargement is dangerous and can spread to surrounding organs.Enlargement can be due to exposure to cold and chill, infectious diseases, excessive sexual excitement, constipation etc. Prostate problems affect many men, especially those in their senior years.
The laser procedure has its fair share of advantages and disadvantages. Still, in most cases, the advantages far outweigh the disadvantages. This is especially true if the procedure is done by a trained and licensed medical professional using FDA approved laser equipment.
Laser surgery is minimally invasive thus the chances of bleeding are minimal. This means that the procedure can also be done on those who are taking blood thinners and those who have bleeding disorders. Laser surgery can correct an enlarged prostate.
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Is Greenlight Right For Me
The best way to find out is by talking with your doctor to determine if GreenLight Laser Therapy is a good treatment for you based on your symptoms and treatment goals. Start by taking our BPH Quiz. Then bring a printout of the results with you to your appointment. Need to find a doctor who specializes in GreenLight Laser Therapy? Use our doctor finder to locate one near you.
Interested in receiving more information? to receive the latest updates and resources about BPH treatment options.
Perioperative And Postoperative Features
Generally, no intraoperative complications were recorded. Two patients experienced early postoperative complications . Median catheterization and hospitalization time was 2 days .
Functional outcomes 6 months after surgery are shown in Supplementary Table 2.
Median Hb, PSA, Qmax was 0,60 g/dl, 1.56 ng/mL, 18.5 mL/s, respectively.
Comprehensively, we recorded a meaningful post-operative improvement in both storage and functional symptoms as well as in global quality of life scores at validated questionnaries .
A significant inverse correlation between the amount of energy delivered on the prostatic tissue and the degree of improvement of LUTS was detected considering the entire surgical procedure. The same analysis applied to the individual steps of the aPVP procedure confirmed a significant inverse correlation for all steps regarding the general improvement in IPSS, while only for steps 1-3 regarding the imporvement in storage LUTS .
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What Are The Risks Of Greenlight Therapy
The Greenlight technique uses an energy beam delivered through a thin laser fiber to safely and precisely vaporize surface tissue.
Short-term studies show that it has fewer side-effects compared to TURP. However, there are risks associated with any surgical procedure.
There is a risk of reoperation after Greenlight therapy . It can cause bladder neck contracture that requires surgical intervention to correct.
Unfortunately, there is a lack of long-term studies evaluating its safety beyond 10-years after surgery. Further safety and efficacy studies are needed to address the cause of reoperation adequately.
Green Light Laser Surgery For Prostate
An enlarged prostate blocks the flow of urine from the bladder. Anyone who has known someone suffering from an enlarged prostate understands the importance of treating this condition that affects older men. Green Light Laser Surgery for Prostate is an effective procedure for treating this condition.
Before this time, enlargement of the prostate was treated either with medication or for the more serious cases transurethral resection of prostate. The aim of either treatment is to free up the passage for the flow of urine from the bladder.
The alternative to transurethral resection of prostate which is an invasive surgery is laser surgery for prostate. This is a non invasive procedure which employs the use of green light laser. This procedure involves the photoselective vaporization of the prostate thereby creating a passage for the flow of urine.
When people hear of lasers, there is a tendency to get worried. There is no need to get worried as this process is a safe and quick alternative to the traditional method. The green light laser also known as KTP laser facilitatesthe procedure being completed with minimal fuss.
Why Is Laser Surgery for Prostate Better?
This method of treating prostate enlargement is preferred for the following reasons:
Are There Side Effects?
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Transurethral Vaporization Of The Prostate / Greenlight
Laser prostatectomy is a minimally invasive procedure to treat BPH. You may also see it referred to as Greenlight PVP, Transurethral Vaporization of Prostate , or laser prostatectomy. A telescope is placed into the urethra up to the prostate, and your urologist then uses a laser to vaporize prostate tissue that is obstructing flow of urine from the bladder.
This procedure has fewer side effects than the traditional Transurethral Resection of Prostate and is much more effective than microwave prostate treatments. Laser Prostatectomy is done under general or spinal anesthesia as an outpatient procedure. Most patients keep a foley catheter for less than 24 hours. Other benefits include long-lasting relief of BPH symptoms, the ability to stop BPH medications, and faster return to normal activities.
Postoperative Course And Complications Within 30 Postoperative Days
Figure 1 shows perioperative outcomes. Data from 8 available studies showed a longer postoperative catheterization time and length of stay in the TURP group : 1.12, 95% CI:1.091.14, p< 0.00001 and RR: 1.16, 95% CI: 1.121.19, p< 0.00001, respectively). Data from ten studies of 1689 patients compared the need for blood transfusion and showed a higher risk of transfusion in the TURP group . Data from ten studies including 1628 patients showed no difference in the risk of urinary tract infections between the two groups . Data from eight studies including 1923 patients showed a non-significant higher risk of transient re-catheterization in the TURP group . Data from eight study including 1705 patients showed a significant risk of higher dysuria/urgency in the Green Light PVP group
Figure 1 Postoperative course. Postoperative catheterization Length of stay Blood transfusion Urinary tract infection rate Re-catheterization Dysuria/urgency incidence.
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What Are The Benefits Of Laser Surgery
- Immediate symptom relief.
- Urine flow improves dramatically after virtually bloodless procedure.
- Patients are typically catheter free within 24 hours many immediately after the procedure.
- Patients are able to return to their ordinary daily activities in 2-3 days.
Massachusetts General Hospital
How Soon Can I Return To Work And Other Activities After Greenlight Laser Procedure For Bph
Most men can return to office work a few days after Greenlight laser surgery for enlarged prostate. Men who drive or engage in potentially dangerous situations should wait until they are comfortable with their urinary function before returning to work. In other words, once urinary urgency and frequency are tolerable and compatible with your work situation, you may safely return to work.
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Post Greenlight Laser Surgery Recovery
I had GL surgery four days ago and would appreciate feedback regarding the recovery process from those that have also undergone this procedure. I currently void every 30 to 60 minutes at night and every 30 to 60 minutes during the day. My flow is a stream for a few seconds then dribbles for maybe 30 seconds. Is this pretty typical? After the surgery I was drinking 1 1/2 liters of water per day but I may reduce this because I am not convinced my bladder is emptying fully. What do you think about this? When I void, it really burns at first and often I will get bladder spasms as well. Do you think the pain is radiated pain from where the prostate was vaporized? Do you think I will see improvement with these symptoms on a daily basis or weekly basis over the next month or so?
3 likes, 163 replies
Posted 7 years ago
I had a similar problem. it was caused by blood clots forming in the uretha and thus the inconsistant flow of urine.I went to A& E because i was unable to pass urine at all at one stage. They flushed out the bladder and it was unbelievable how many clots there were. They are unlikely to disove them selves. BVut this is some thing yiu need to check out.
Posted 4 years ago
I have had the surgery 2010 and since been having problems with bladder not emptying it sounds like Im going to have it redone again
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Strengths And Limitations Of This Study
This updated meta-analysis included a larger number of studies involving more participants which adds precision to previous findings.
This study analysed both safety and efficacy, focusing on sexual functioning and quality of life measures because lower urinary tract symptoms treatment related adverse events have a hugely detrimental impact on ones psychological well-being.
Quality assessment methods used did not highlight substantial differences between studies because blinding is not possible given the characteristics of the two interventions under investigation.
Due to the limited number of studies in this field, we were unable to conduct subgroup analysis around laser power which is necessary to identify the most effective/efficient standard.
Surgical experience with laser technology, drop outs and withdrawals as well as other important factors were seldom reported in any detail which inhibits further analysis.
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Where To Get Greenlight Pvp Prostate Laser Surgery In Nyc
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
What Will Happen During Prostate Pvp
You may need to urinate before your procedure. You may be given medicine to keep you asleep during the procedure. Or, you may be given medicine to keep you calm and relaxed. With this medicine, you will be awake during the procedure but you will not feel pain. Your healthcare provider will insert a scope into your penis through your urethra. He will insert the laser through the scope and move it to the prostate. He will use the laser to vaporize the enlarged prostate tissue until the blockage is removed. You may need a catheter after the procedure to drain urine from your bladder.
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