What you need to know before a GreenLight Laser Prostatectomy

[@lesbrown8099]

Just a note of appreciation for this video… I watched it prior to my Greenlight procedure 4 days ago… all the information in the video accurate and useful…

[@TheProstateClinicTPC]

Thx for your feedback Les👌🏻 good luck

[@treasureisland-st.petebeac5701]

Great presentation! very thorough and educational! Thank you.

[@TheProstateClinicTPC]

Glad it was helpful!

[@alshunneson]

Dr. Chabert, at 7:05, you bring up the healing process and scab separation. What is the likelihood of blockage from the material? Also, during the procedure, there appears to be lots of fluid in the prostate cavity that's being formed. What is it? Thank you for your very informative videos!

[@TheProstateClinicTPC]

Hi Al thx for your question. Whilst is it possible that this tissue could cause a blockage it is less likely. Most men pass this tissue with little difficulty. It is not fluid that is form but gas. Hence the term vaporisation which converts solid to gas. Hope this helps👌🏻

[@vicentepbsaraiva]

Very imformative. I am 65, I have a long history of issues EPH since my early 40s. Lately it has worsened dramatically. My Daddyvhad prostate cancer on his middle 60s. I am very hasitating to go trhoug any type of proceedures, but I feel that soonbI might have no choice. Feel friken scary! Thank you for you detailed content, it is very helpful.

[@TheProstateClinicTPC]

Thx for the feedback. 🙏🏻 good luck

[@amrikjohal1240]

Very good information about proster.thanks again.

[@TheProstateClinicTPC]

👌🏻

[@johngoard8272]

I am due to have one of these surgeries when it can be arranged. Thanks for the great explanation.

[@TheProstateClinicTPC]

Good luck John

[@boltnutts]

I have had the rezume procedure 4yrs ago it seems to be close to same steps to follow experience wise.But a bit more aggressive😬 I guess I worry about the gate opened wide and I'm pissin on myself. Or down the road having to resort to self catheterization I did experience the retrograde when on the Flomax I'm 61 I told my doc I guess I'm old enough I dried up he said a side effect of Flomax I said good I thought I was a kid again. Lol it was explained it would be a dry ride...I said I was done making my family and I wasn't into making movies. I didn't need it. Right?? No fuss no mess. And I know there's no answers to what might be down the road. I'd just hope this fixes things a bit longer than my experience with rezume. Thank you for posting this information it is what it is..I just try to stay positive..

[@TheProstateClinicTPC]

Thx for sharing👌🏻

[@DGAWDGAW]

Very clear and understandable explanation. Although I have read that there is a risk of having incontinence after the surgery, I mean not just after, but as an unwanted side effect that may be permanent. Is that so? If so in what percentage? Thanks

[@TheProstateClinicTPC]

Stress incontinence is very rare. Usually less than 1%

[@tackmack]

Firstly, very lucid down to earth explanation. Thank you! Question - most of my symptoms are obstructive not irritative. Immediately - first week - post op should I expect there to be a lot of urgency and frequency or "just" dysuria?

[@TheProstateClinicTPC]

Hi and thx for your comment. Most people with significant irritative symptoms i counsel to expect these to get worse for the first few weeks before improving. A proportion of people also will need bladder medication in the short term whilst recovery is taking place. Good luck

[@tomblount5635]

Thank you for the information

[@TheProstateClinicTPC]

My pleasure Tom👌🏻

[@robertreynolds8092]

I had complete urinary obstruction immediately after a hernia surgery. I had a catheter for 5 months. It took 4 urologists 5 months to figure out that 1) I had BPH and 2) I had prostate cancer. I had greenlight as soon as possible. I had a catheter for 3 days over a holiday. Catheter came out and I could pee! It took 8 weeks to get my bladder back to normal.

[@TheProstateClinicTPC]

Thx for sharing. Glad to hear it went well after GreenLight👍🏻

[@colm5516]

Very informative doctor!!!

[@TheProstateClinicTPC]

Thx🙏🏻

[@patrickrwhite8354]

I am going for this surgery relatively soon and was wondering if the urethra stays in tack or does the laser obliterate that as well and what about leakage after the recovery time has been completed.? Thank you.

[@TheProstateClinicTPC]

Hi Patrick this is a common question I receive. The urethra is in essence part of the prostate at that level so is removed together with the over grown tissue. The lining of the bladder grows down into the prostate during the healing process to create a “new” urethra. There are two different types of leakage. One which is related to the overactive muscles of the bladder which settles with time. The other is related to damage to the sphincter muscle. The later is far less common. Most leakage tends to be slight and self limiting. Talk to your doctor to o rain specifics with regards your individual risk. Good luck👍🏻

[@davidtindell950]

Excellent explanation. Unfortunately, I endured the so-called "Greenlight" Laser Prostatectomy here in the U.S.A back in mid-February 2022 and have had nothing but bladder pain, blood and spasms since then. I have now had to wear a catheter for five months. Several attempts to remove the catheter have resulted in painful spasms, urine blockage and bladder filling to 2000 mL. As much as I would like to fly to Australia, that is not practical and I must seek some alternative help here in the U.S.A. Any timely suggestions would certainly be appreciated as I feel so badly that I have had to update my life insurance policy. My doctor has suggested a new "water pressure" procedure but I have experienced so much pain and continual discomfort that I am skeptical about anything other the full prostrate surgery !

[@TheProstateClinicTPC]

Hi David thx for your feedback and sorry to hear that you have had difficulties. It certainly sounds like your situation is not the norm. As I’m sure you can appreciate there are several factors which determine the outcome from a particular treatment. Unfortunately I cannot provide you advice for your location other than making sure your situation is thoroughly investigated before proceeding on with additional treatment. Good luck

[@josecarlos-gu6id]

Can green light be a solution for crónic prostatitis I have been prostatitis for several occasions and the las one las 4 years to go at the moment I have problem I get hit with covid one June 25 2022 and I have a not nice síntomas this time may prostate is 56 cc but may síntomas are ugly

[@TheProstateClinicTPC]

GLP is a treatment for BPH but removal of overgrown tissue can help some with chronic prostatitis👌🏻

[@samadkins4240]

Best information on Green Light Laser I've seen, thank you for taking the time to post it. I had the procedure three days ago and was released immediately after recovery with a catheter and told to return next morning which I did. I wasn't asked to pee while in the doctor's office but told to return if I was not able to pee after I got home. There was quite a bit of blood each time I went for the first several times which includeded what appeared to be dark matter or thicker masses of blood. Now, after 3 days, urine is pink with some red toward the end, and every time I feel the urge to pee, I'm also feeling the urge to pass gas or have a BM, which has not been easy even after taking a stool softner. Is what I am experiencing fairly normal?

[@TheProstateClinicTPC]

Sounds like u r on track👌🏻 good luck and thx for the feedback

[@carolineebden2421]

Hello. My father is due to have surgery for BPH and I was wondering what the advantages of laser are over TURP?

[@TheProstateClinicTPC]

Hi Caroline a Laser is associated with less bleeding risk, lower risk of a blood transfusion and shorter catheterisation time on average. Both are effective ways to unblock a bladder. Good luck to your dad👍🏻

[@jamesshall5160]

Hello Doc, thanks so much for this video. Just a question, is this procedure for enlarged prostate or prostate cancer treatment? Thanks

[@TheProstateClinicTPC]

Hi James this is for an enlarged prostate causing urinary symptoms

[@nitin6227]

When can we have alcohol after this surgery.

[@TheProstateClinicTPC]

You can have alcohol straight away but be aware that alcohol is a diuretic so especially after surgery this can cause a big increase in frequency and urgency. Good luck

[@tonyp.2482]

Hi Doctor. Thank you for your video it set my nerves at ease due to being scheduled next month. I have a question. After having this Green light surgery and after all has healed. When ejaculating dry, where does the semen go? And is it bad if it stays in the body? Thanks in advance.

[@TheProstateClinicTPC]

Hi Tony the ejaculatory fluid goes backwards into the bladder. This is not harmful in any way. Usually this is evacuated the next time a man pees. Good luck with your treatment👌🏻

[@tonyp.2482]

@@TheProstateClinicTPC thanks for response!

[@richardkremmen7811]

Thanks for the video! Two questions which you answered when I queried in response to your video about Rezum that I'd like to ask about Green Light: what fr. size please is the instrument that is inserted in the urethra? Also, if a man is already self catheterizing (due to BPH obstruction) can he avoid the post op indwelling cath? Thank you.

[@TheProstateClinicTPC]

For GreenLight the cystoscope sheath is 22.5 Fr. I leave an 18 Fr catheter after the procedure. This is always inserted.

[@mikew4014]

Per the results of my cystoscopy, I have a large median lobe that is creating an obstruction (a intravesical prostatic protrusion I believe is called). Would that be removed as part of a typical green light procedure or would another treatment procedure like Rezum be better?

[@TheProstateClinicTPC]

Hi Mike thx for your question. Both GreenLight and Rezum would treat an enlarged median lobe. Both treatments are effective at unobstructing a bladder. GreenLight has been around for a longer time where as Rezum is a newer treatment with shorter follow up data. Both are good options with slightly different pros and cons. 👌🏻

[@daver2964]

I am not a doctor. But, median lobe would mean it's protruding jnto bladder. Due to sensitive nerve endings, wouldn't laser have probability to affect those nerve endings as prostate is removed nearest the bladder ?

[@TheProstateClinicTPC]

Hi Dave yes a median lobe is a projection of the prostate which grows into the bladder. Functionally they can act like a ball valve resulting in obstruction. Men with median lobes tend to, but not always, have a poorer response to medication than those without. Surgery/ laser is very effective at removing this obstruction. Most men experience some stinging and burning when they pee following surgery which is usually self limiting within a few days.

[@sundarrajan6285]

Thank you for a very lucid explanation of all aspects of Laser Prostatectomy. This is the best presentation of numerous that I have seen recently. I underwent Thulium Laser Prostatectomy for approx 50cc BPH (lateral lobes). I am into the 3rd week post the surgery. From the 8th day post surgery till date (19th day) the first few drops of urine is pink and then the rest of the pee is clear.? How long before the pink drops stop?

[@TheProstateClinicTPC]

Hi Sundar thx for posting. Blood in your urine after this surgery can be variable and usually lasted for a few weeks. Can last a little longer in those men with larger prostates or who are taking blood thinner medications. Good luck👌🏻

[@jesterraj]

How long does the stinging and burning last?

[@TheProstateClinicTPC]

Hi Raj it usually settles within the first week👌🏻

[@patrickrwhite8354]

I am also type 2 diabetic are there any concerns that I should be worried about with this surgery? Secondly, is there a possibility of having too much prostate removal or will the doctor only remove the necessary overgrowth tissue of the prostate? Thank you and I am quite nervous.

[@TheProstateClinicTPC]

Hi Patrick thx for your questions. No there is nothing of particular concern related to your diabetes. Ensure you have good control preop. You will be given antibiotics at the time of your surgery to reduce the risk of infection. The aim of the surgery is to remove excessive tissue in the transition zone or the area around the outlet pipe only. Good luck👍🏻

[@roger1uk676]

Do you lose your internal sphincter with this procedure?

[@TheProstateClinicTPC]

The bladder neck which is what I think you are referring to is opened up during this procedure and others which create a cavity. This doesn’t not affect continence. The external sphincter is the key structure in securing urinary continence.

[@roger1uk676]

@@TheProstateClinicTPC thank you!

[@loveelijah1617]

my dad just had it and just after few days urine not coming out from the catheter. what can we do?

[@TheProstateClinicTPC]

Hi thx for ur question. Not exactly sure what u mean? Does he still have a catheter in place? Is it completely blocked with no urine coming out? If this is the case please contact ur dr for instructions

[@dewangpatel]

@Elijah, I hope he is feeling better now. i am confused of your question ? Is he not able to urinate or he has catheter attached and no urine is coming out in bag ?

[@loveelijah1617]

@@TheProstateClinicTPC so the uro said the excess tissue is blocking the catheter that is why urine is not coming out (is that possible?). he changed the catheter and gave him antibiotics and we were told if still the same he will put a hole on his belly to move the catheter there and if it is still not working he will have another surgery. we thought after the green light laser problem will be solved but now the tissue is blocking the catheter.

[@TheProstateClinicTPC]

Hello… sometimes there can be debris after surgeries which can block off urinary catheters. Staying hydrated to flush away any small pieces of tissue can help. How long does he require the catheter for?

[@asadfaruqbuttar5264]

Sir does this effect sexual health? Lastly is this a permanent solution or it has to be repeated after some years?

[@TheProstateClinicTPC]

It has a low risk of changing erectile function but high probability of ejaculatory dysfunction. Good luck

[@mohamedissa530]

After 18 days of laser thole-um can I drive my car for 3 hours contentiously.

[@TheProstateClinicTPC]

Hi Mohamed that’s a question for your doctor to answer as they will know your specific surgical details and what they are happy with. Hope you are recovering well👍🏻

[@artmaltman]

Is this an option for people who have a tumor in the prostate, and, would it be more likely to preserve continence? (19 months post robotic prostate removal in NYC, I still have very bad incontinence. It is remarkably depressing and socially isolating.) In general, what do you do to minimize the risk of long term incontinence when removing a prostate? ALSO, how on earth do you get only 1% of patients with erectal dysfunction after removing prostate? Here in the States it is well north of 50%, with ED -- and that includes erection with 100mg of Viagra as a "success".

[@greganderson5339]

Year old...things seem better and advanced now.

[@rolandomariofranco]

What is the average age of a man that undergo green light laser surgery. Is age matter as far as recovery is concerned and some other aspects before and after the surgery.

[@TheProstateClinicTPC]

Average age 65

[@mr555harv]

Quality of life . Urinating improved. But, what do the men say about sex. How much diminution occurs in the joy of sexual relations, for both husband and wife? How noticeable is the change?

[@TheProstateClinicTPC]

Hi there thx for ur question. Erections are very unlikely to change after this surgery. Ejaculation does change in almost every man and should be expected. This is called retrograde ejaculation where no fluid is emitted during orgasm. This can change the quality of a man’s orgasm which for some is less pleasurable for others the same pleasure is experienced. Hope this helps.

[@daver2964]

You speak as if its expected that post surgery void will be good! What happens if after 3x you still have 6 ounces in bladder

[@TheProstateClinicTPC]

Hi Dave without knowing your specifics if you still have ongoing retention of urine then this would suggest that either there is a pump problem (bladder) or still residual obstruction. If you have had x3 procedures I would assume that there is no longer obstruction. I would suggest you discuss your situation with your urologist about the possibility that your bladder muscle may not be working properly. I hope this helps.... Good Luck

[@romualdbiblocz]

Why The doctors don't wanna use this method to treat prostatitis? , After all prostatitis also cause exacly the same urinal problems (LUTS) as BPH. So many people who suffer prostatitis are sentenced to taking harmful antibiotics for many months or even years and yet the disease returns 😥

[@solorking]

This surgery ruin my sex life, dry unpleasant come.,no longer able to get a strong erection ,unable to pernitrate to soft and no precome fluid bone dry .the doctor did not did not give me info on the side effects, so think about ?

[@TheProstateClinicTPC]

Hi Joseph thx for your comment. Yes cavitation surgery ie surgery which physically removes prostate tissue causes retrograde ejaculation or a dry organism which some men indicate can reduce the intensity of their orgasm. This is something to consider when deciding on which treatment choice is most suitable for a particular man. Some treatments such as Rezum and UroLift have a much lower likelihood of causing this side effect but they are not appropriate choices for all prostates.

[@artmaltman]

If you know how to remove a prostate without causing long term erectal dysfunction and long term incontinence, PLEASE make this more well known! The severe incontinence alone has destroyed my life.

[@TheProstateClinicTPC]

Sorry to hear ur story. Have a look at this video to see if Dave’s advice can help. Good luck👍🏻 kzbin.info/www/bejne/h3nah5qihbaFldk

[@Lyfehurts66]

No ejaculation oh no smh..