Laser PVP surgery

About

Mayo Clinic helped develop the PVP laser vaporization technique in 1997 by adapting a potassium titanyl phosphate (KTP) laser system for prostate surgery. Laser PVP is sometimes called green light laser because of the laser's color, due to a chemical used in the treatment.

Laser PVP prostate surgery

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Illustration comparing enlarged prostate before and after surgery

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Lasers are commonly used to treat prostate enlargement in men. A variety of lasers are available that use varying wavelengths to treat the prostate in slightly different ways. Another common laser treatment of the prostate (also available at Mayo) is holmium laser enucleation of the prostate (HoLEP).

Laser PVP has emerged as a safe, less invasive and effective alternative to transurethral resection of the prostate (TURP), the long-standing BPH treatment of choice. One Mayo study assessed the results of treatment in almost 100 men followed for five years. Men reported significant improvement in symptoms and urinary flow rates after the procedure, which continued for the length of the study. Complications were mild, and no one developed incontinence or a new case of impotence. A number of men did report experiencing retrograde ejaculation, in which semen enters the bladder instead of emerging through the penis during orgasm.

The main disadvantage of laser PVP is that sometimes not as much prostate tissue is removed as with TURP. There is also limited information about long-term results of the treatment.

Candidates

People diagnosed with BPH that can't be controlled through medication or alternative therapies are good candidates for laser PVP. Because laser PVP vaporizes tissue rather than cutting or scraping as in TURP, there is generally less blood loss. So the procedure is particularly advantageous for people with blood-clotting disorders or those taking blood thinners, who would not be good candidates for surgery.

Prostate obstruction is usually due to benign prostatic hyperplasia (BPH), but can occur because of more uncommon conditions, such as prostate cancer or an infection of the prostate (prostatitis). Your doctor will conduct a thorough evaluation to confirm BPH as the principal cause of your urinary condition and will suggest treatment options, including PVP.

What to expect

Laser PVP can be an outpatient procedure or an overnight stay. It is not uncommon for patients to require a catheter for up to 24 hours following laser PVP. Your surgeon may recommend keeping a Foley catheter longer.

Some men may experience pain, which can be managed with medications, as needed. Discomfort can include burning when you urinate (dysuria) or pressure in your rectum.

Laser PVP may, in some cases, weaken the muscles controlling urination. However, bladder control improves over time as muscles heal and any swelling subsides. In most cases, bladder control occurs rapidly after surgery.

You can return to normal activities and work within seven to 10 days following laser PVP, depending on the nature of your work. Your doctor may suggest avoiding sexual activities for several weeks to prevent delayed bleeding.