Problems and Treatments

Often the symptoms of BPH can be controlled with medication either to shrink the prostate or to reduce the muscle tone in the gland to allow urine to flow more normally. For many patients daily tablets will be all they need. For other patients however especially if they have severe symptoms, urinary tract infections or a very poorly emptying bladder, a surgical treatment is more effective.

Green Light Laser or PVP

What is it?

Green Light Laser or PVP (photo selective vaporisation of the prostate) therapy is a safe, effective procedure for the treatment of the enlarged prostate with less morbidity than the standard TURP.

The treatment is delivered to patients using a high powered laser, which reduce the size of the prostate gland by destroying and vaporising excess tissue. The procedure, which can be conducted under general anaesthetic with the patient asleep or under a spinal block with the patient awake, takes an average of 60 to 90 minutes (under general anaesthetic).

What are the risks?

It is extremely safe and there is minimal bleeding associated with this technique. Risk of complications is low and patients can usually return home within 24 hours. Studies also show that there is no increase in the need for repeat procedures following Green Light Laser and side effects are much reduced.

Safety

Green Light Laser was first performed in the UK in October 2002 and approved by the National Institute for Clinical Excellence in May 2005.

Tim Larner was one of the first pioneers in the UK of this treatment and has been using it for over 5 years.

Holmium Laser

What is it?

Holmium laser treatment is a safe and effective method of removing obstructing prostate tissue.

It is a less invasive treatment option to traditional surgery (TURP), and provides immediate relief of symptoms for the patient meaning quality of life is quickly improved.

How does it work?

Holmium laser treatment is administered to a very high degree of precision, using a flexible fibre to transmit energy to the prostate.

The surgeon uses the laser to cut through the excess prostatic tissue, with a significant reduction in bleeding. The main advantage of this technique is that it does not hold the same side effects often associated with common standard procedures (such as TURP and open prostatectomy). Many patients are also able to be admitted just for the day of the procedure.

The procedure takes 50 minutes on average, but this will vary dependant upon the size of the prostate, surgical technique, amount of prostate removed. As a lot of prostate tissue is removed efficiently, this is now considered the "Gold Standard" treatment for very large glands.

What are the risks?

Risk of complication is low with Holmium laser treatment. As with the PVP, there are also fewer risks for post-operative complications than TURP and recovery time is shorter.

Most patients experience little or no bleeding, and go home without a catheter after an overnight stay. Pain medication is not usually required and patients can return to their normal daily routines very quickly.

Safety

The tissue removed with the Holmium laser is sent for examination under microscope, to check for any evidence of prostate cancer.

Holmium laser can also be used in a combination with specific prostate cancer treatments giving excellent results.

Paul Miller is one of the countries leading experts with the Holmium laser.

TURP

What is it?

Transurethral resection of the prostate (also known as TURP), is the most common surgical treatment for BPH. The TURP is performed by inserting a telescope through the penis and removing the prostate piece by piece.

How does it work?

The operation involves removing tissue by electro-resection and is usually carried out under spinal or general anaesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete.

What are the risks?

Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. Post-op complications include bleeding (most common) and problems with blood electrolyte levels due to absorption of irrigating fluid.