Laser Prostate - The Operation

Photoselective Vaporisation of the Prostate (PVP) uses a powerful, green laser to vaporise the prostate and hence produce a reduction in prostate size like the TURP. The green light is selectively absorbed by the red prostate tissue hence “photoselective”. The laser is delivered through a fibre passed down a telescope (cystoscope) through which the prostate can be viewed. There is minimal bleeding associated with this technique and with small prostates it is possible to leave the patient without a catheter after the operation.

The operation can be conducted under general anaesthetic with the patient asleep or under a spinal block with the patient awake. The type of anaesthetic will be decided with the anaesthetist based on preference and safety.

Once anaesthetised a telescope is passed down the penis and into the bladder. The bladder and prostate are thoroughly inspected.

Using the laser under direct vision the obstructing prostatic tissue is vaporised creating a cavity to allow passage of urine.

A catheter may be placed if necessary at the end of the procedure.

If a catheter is placed then the patient will need to stay overnight for removal of the catheter the following morning.

The following clips show parts of the operation for your information

This first clip shows the view through the prostate towards the bladder. The obstructing prostate can be seen as the red fleshy lobes to either side (right bigger than left here) stopping the free passage of urine. Comparison can be made with the view on the last clip.

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This clip shows the initial vaporisation of the median lobe of the prostate at the bladder neck. The aiming beam of the laser appears as a red dot. Once the laser is activated streams of bubbles can be seen as the prostate vaporises. The reaction of the prostate is checked after a few seconds to ensure good vaporisation. There is no bleeding

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Further vaporisation of the left side of the prostate is shown. Again there is no bleeding. Just at the end of the sequence the white fibres at the edge of the obstructing prostate can be seen.

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Once the majority of the left side has been cleared the laser is used to do the same on the right.

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Towards the end of the procedure there is a good channel through the prostate and any untidy areas can be further vaporised. Further vaporisation was undertaken to the median lobe before the end of the procedure but the entire procedure on this moderately enlarged gland took 27 minutes. Comparison can be made to the initial view above.