A new prostate-shrinking, laser therapy at New Hanover Regional Medical Center now gives men undergoing surgery for benign prostate enlargement the green light, literally, to return home within hours of their procedure.
So-called because of the wavelength of light it emits, the GreenLight laser vaporizes prostrate tissue around the urethra, increasing urinary flow while all but eliminating bleeding and the need for inpatient hospitalization.
“The basic concept is you take the laser and touch the prostate, and the laser generates such heat that the tissue vaporizes,” said Ed Whitesides, MD, a Wilmington urologist with Urology Associates of Southeastern North Carolina. “Basically you just boil the tissue away.”
The new laser technology supplants older treatment methods for enlarged prostate, or benign prostatic hyperplasia, including microwave thermotherapy, hot water-induced thermotherapy, various medications and, for over 70 years the gold standard of treatments, Trans Urethral Resection of the Prostate, or TURP.
“It used to be up until the early 1980s you either lived with your symptoms or had a TURP, in which an electrified whittling device shaves tissue out of the way, opening up the water channel and restoring more normal urination,” he said. “Since that time a variety of medicines have been developed to help control the symptoms of enlarged prostate, but they require a lifelong commitment.”
The hour-long TURP procedure can have drawbacks – primarily blood loss and overnight hospitalization.
“TURP is a safe, effective operation, but the prostate is a vascular organ,” he said. “The electrified resectoscope or whittling device cuts across blood vessels. Almost universally after TURP, the patient has to be admitted to the hospital where a special catheter is put in place.”
But because GreenLight’s cauterizing effect significantly reduces, if not eliminates, blood loss during surgery, most patients return home within a few hours of surgery, he said.
“The laser totally seals off blood vessels the minute it touches them, so it’s essentially a bloodless procedure we can do on an outpatient basis,” Dr. Whitesides said. The procedure is performed under general or spinal anesthesia, he said.
At present, NHRMC’s GreenLight laser generates 80 watts of power. Recent approval for a system upgrade, however, will soon result in the use of a 120-watt laser for patients with prostates in excess of 50 grams.
Jim LaSure, one of Dr. Whitesides’ GreenLight patients, said he suffered no pain and “very little” bleeding with the procedure.
“I had some apprehension about the procedure, but didn’t want to continue taking medication, and I was still getting up at night or at a restaurant or movie to use the bathroom,” LaSure said. “I’m very pleased with the results.”
Between November 2005 and June 2006, of the 101 GreenLight laser procedures performed at NHRMC, 87 were outpatient. In 2000 it was estimated men aged 20 years or older would make 4.5 million doctor visits with enlarged prostate listed as the primary diagnosis.
“If you have frequent urination during day and night, or there’s a slowing down of the urinary stream, or you feel like you don’t get all the way empty, you may want to consider this procedure,” Dr. Whitesides said.For information on a physician referral for enlarged prostate, please contact VitaLine at 888.815.5188.