The Department of Urology offers a wide range of surgical therapies for benign prostate enlargement (synonym: benign prostatic syndrome, prostatic obstruction syndrome, benign prostatic hyperplasia, BPH). Depending on the extent of the enlargement and existing secondary diseases, we can determine and implement the optimal therapy option for each individual patient. In addition to the classic electroresection of the prostate (TUR-P), we also use state-of-the-art laser procedures (Greenlight™- Laser, Thulium Fiber Laser) as well as the gentle REZUM™ water vaporization.
What is GreenlightTM Laser Therapy?
Greenlight™ Laser Vaporization of the prostate is a particularly gentle and low-bleeding procedure for benign prostate enlargement, which allows us to perform low-risk surgery even on patients on ongoing blood thinning medication or those with severe secondary cardiac conditions. The operation has been performed in our clinic for many years. Currently, we are using the latest generation Greenlight laser, the state-of-the-art GreenLight XPS™ Laser Therapy System (180 watts).
The GreenLight™ laser is based on a technology called photoselective vaporization of the prostate (PVP), also known as KTP (potassium titanyl phosphate) laser. The laser beam has a green color and a specific wavelength of about 532 nanometers. This wavelength is strongly absorbed by hemoglobin in the blood, which means that the laser beam easily penetrates blood vessels and seals them at the same time. In the very well perfused prostate, the laser energy is therefore absorbed extremely effectively. This leads to rapid and intense heating of the superficial layers of the prostate tissue, which in turn leads to vaporization of the tissue.
What are the advantages of GreenlightTM laser vaporization?
Especially due to the almost bloodless operation, there are a number of advantages of the gentle laser surgery compared to electroresection of the prostate (TUR-P) with equally good functional results:
- Treatment of patients who cannot discontinue blood-thinning medications (e.g., aspirin/ASS, Plavix, Eliquis, Marcoumar)
- Treatment of patients with severe secondary diseases in whom TUR-P is not possible
- Short catheter dwell time
- Short hospital stay
- Short recovery time and faster return to a stable state of health
- No wash-in syndrome (so-called TUR syndrome – wash-in of larger amounts of irrigation solution into the blood vessel system).
What is the procedure for GreenlightTM laser surgery?
During the operation, under video control (with a cytoscope), a special laser fiber is introduced to the prostate via the urethra. The high-energy green laser light is absorbed by the well-vascularized prostate tissue, resulting in vaporization of the excess prostate tissue. This is done layer by layer and with high precision. At the same time, there is immediate hemostasis in the underlying tissue layer, so that the operation is practically bloodless. Dead tissue that does not vaporize immediately is naturally excreted through urine in the days following the procedure.
Immediate removal of the excess prostate tissue reopens the urinary tract, resulting in rapid improvement of urinary symptoms.
The operation is performed under general or spinal anesthesia and lasts between 30 and 90 minutes, depending on the size of the prostate. At the end of the procedure, a bladder catheter is temporarily inserted through the urethra to drain urine. The urethral catheter is usually removed within the first two days after the procedure. After that, urination is possible directly. Urinary symptoms improve steadily until complete wound healing after about 4 to 6 weeks.
Virtually no impairment of erectile function is observed after Greenlight™ laser surgery. Retrograde ejaculation (reflux of seminal fluid into the bladder), which regularly occurs after surgery, can be avoided by a specific surgical technique (so-called ejaculation-protective surgery). In case of an increased risk of recurrent constriction of the prostate, this option must be discussed in detail prior to surgery.
For whom is the GreenlightTM laser surgery suitable?
Not all patients with BPH are suitable for Greenlight™ laser therapy. The choice of procedure depends on several factors, including the size of the prostate and the patient’s individual health conditions. Optimal conditions are a relatively small prostate gland, a small middle lobe (part of the prostate) and when patients are on blood thinners.
How much does the GreenlightTM laser surgery cost?
The costs are covered by health insurance.
Why to the USZ?
The USZ offers university-based, internationally recognized cutting-edge medicine and is one of the best hospitals in the world. The Department of Urology at the USZ is also committed to innovation in the field of endourology and offers a range of the latest laser technologies that are gentle and effective.
Research and quality assurance
GreenLight™ laser surgery has been scientifically studied in our clinic since 2006. The results of these investigations have been published in a number of high-ranking international journals and presented at the most important urological congresses worldwide (see below). The research work was awarded poster prizes by the German and European Society of Urology at several congresses and the prestigious Mauermayer Prize of the German Society of Urology in 2009.
For more information on all treatment options for benign prostate enlargement and the clinical picture, click here: