Why haven’t urologists embraced the GreenLight Laser for enlarged prostate?


Traditionally urologists have surgically treated an enlarged prostate associated with obstructive voiding symptoms by performing a TURP (transurethral resection of the prostate).  When you do a TURP you don’t have to wear glasses (the GreenLight Laser glasses change the color of everything the surgeon sees and can be uncomfortable) and the action of the urologist’s fingers on the resectoscope has a direct effect on the resectoscope loop which does the removal of the obstructing prostate tissue. The TURP is one of the signature procedures that all urologists perform in residency and it is still considered the “gold standard” for the treatment of BPH.

Enter the GreenLight Laser-You have to wear the uncomfortable glasses which changes the color of everything (including blood-it is no longer red), the instrument you use is smaller than a resectoscope and so there is less volume of the irrigation fluid which affects visibility, the fiber does not cut like a TURP but vaporizes, the laser comes off at an angle (so unlike the resectoscope and TURP the action of the laser does not match the fingers and is an unnatural maneuver for the urologist accustomed to a TURP), at times because of the angle of the laser light goes away from the fiber and the urologist’s field of vision it is sometimes difficult to actually see where the  laser is contacting the prostate, and finally because of the smaller instrument and as a result less irrigation fluid-any bleeding makes a much bigger difference in visibility than the same amount of bleeding with the TURP.

So…if the GreenLight is so “bad and difficult” why do some urologists-like yours truly- prefer it as their BPH surgical modality of choice?  It takes less time to perform, there is less bleeding, the catheter can come out sooner and it can be done almost exclusively on an out patient basis. For our practice, the ability to offer this procedure to our patients in our ambulatory surgery center represents a vast advantage in not having to go to the hospital and what that entails.

We do GreenLights all the time at our surgery center look forward introducing you to the procedure anytime.  Contact us 24/7 and leave your number below and we’ll call you for the consultation.  Below the contact form is an actual GreenLight procedure performed by Dr. McHugh if you want to see what the urologist sees.

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