Green lig­ht la­ser for the tre­at­ment of be­nign pro­sta­te en­lar­ge­ment

Laser applications offer advantages over TUR-P in the treatment of benign prostate enlargement, particularly with regard to the effectiveness of haemostasis. At the Claraspital we use the latest generation of green light lasers (XPS, 180 watts).

The procedure is performed under general or spinal anaesthesia and takes 30 - 90 minutes, depending on the size of the prostate. The urethral catheter is usually removed within the first two days. Water can then be released directly. There is a steady improvement in urination until the wound has healed after around 4 to 6 weeks.

The operation has no negative effect on potency or erectile function. However, in most cases there is a backward ejaculation (into the bladder). The seminal fluid is then excreted during the next urination.

The effective haemostasis of the laser offers particular advantages for high-risk patients:
Virtually haemorrhage-free, gentle surgery.

• The procedure can be carried out with ongoing blood thinning. It is no longer necessary to stop taking aspirin, Plavix or Marcoumar
• It is extremely rare for irrigation fluid to enter the systemic circulation.
• Patients for whom a conventional electroresection of the prostate (TUR-P) would be too risky due to severe secondary diseases can be operated on with the Greenlight Laser in most cases.
• Short catheterisation time and short inpatient stay.

The laser is called green light because of the wavelength of the light that it emits in a bundle. At 532 nanometres, the wavelength is in the green range. This gives the system very special properties that distinguish it from previous laser applications.
The penetration depth of the laser energy into the prostate tissue is less than one millimetre (0.8 mm), as the green light is strongly absorbed by the red pigment of the blood cells (erythrocytes). The laser energy is therefore very well absorbed in the prostate, which is very well supplied with blood. This results in rapid and strong heating of the superficial prostate tissue layers, which leads to evaporation (vaporisation) of the tissue.

At the same time, a superficial coagulation zone is formed, which re-adheres the opened blood vessels. In contrast to previous laser systems, the excess prostate tissue is removed immediately in real time and not only rejected by the body after several days and excreted via the urethra. Similar to conventional electroresection of the prostate, Greenlight laser vaporisation of the prostate leads to an immediate dilation of the prostatic urethra.