Green Laser Treatment for Prostate Cancer in India

Green light laser surgery for the prostate refers to Photoselective Vaporization of the Prostate using a green light laser (also known as KTP laser). It is used in the treatment of Benign Prostatic Hyperplasia or more commonly known as enlargement of the prostate gland.

Green light laser treatment is a minimally invasive therapy that evaporates prostate tissue which is blocking the flow of urine from the bladder. It uses a unique high power laser energy which is selectively absorbed by blood within the prostate tissue which leads to vaporization and removal of the tissue, leading to an open channel for passage of urine. At the same time, the laser seals blood vessels beneath the area of vaporization which results in substantially less bleeding, compared to traditional traditional transurethral resection of prostate (TURP). There are much fewer side effects and recovery is much quicker.

Is Green Light Laser treatment suitable for all patients?

This treatment is suitable for almost all patients with prostate enlargement who require surgery or not responding to medical (drugs) therapy. Prostate drugs are initially prescribed to patients with enlargement but some patients will progress and will require surgery. Surgery is also needed in patients who have complications such as bladder infection, bladder stone, inability to pass urine (retention) or kidney failure.

As green light laser has the additional ability to control and decrease bleeding during surgery, it has advantage in patients who are taking blood thinning medications such as Aspirin or patients who are taking anti-coagulation drugs such as Warfarin.

How does this compare to a standard TURP operation?

For decades, the gold standard for treating BPH has been a transurethral resection of the prostate (TURP) operation. During a TURP, an electrical cutting loop is passed down a cystoscope to chip away the obstructive prostate from the inside to create an open channel. The green light laser technology has been improved over the years such that it may now be considered the new gold standard treatment because it combines the excellent long term results that one gets with traditional TURP, with some other advantages.

The advantages it has over a standard TURP are:

• Less bleeding during and after the procedure
• Less need for blood transfusion.
• Faster recovery
• Patients go home earlier.
• Earlier return to work.
• Patients can stay on blood thinning medications during surgery
• Some patients cannot come off their blood thinning medications because of their medical conditions.
• Green light laser surgery is ideal for these patients.
• Shorter (or even no) post-operative catheter time
• Catheter time is usually < 24 hours as compared to 2 to 3 days for standard TURP.
• Less risk of water intoxication
• In standard TURP operations, patients may absorb the irrigation fluid and become ‘water-intoxicated’ which can potentially be dangerous.
• In green light laser surgery, because opened blood vessels are quickly sealed, less fluid is absorbed through these vessels, hence reducing the risk of water intoxication.
• Potentially less risk of erectile dysfunction (ED)
• The reported rate of ED with laser surgery is < 1%, whereas in standard TURP, it is about 2% - 4%.