Photoselective Vaporization of the Prostate (PVP)
Photoselective Vaporization of the Prostate (PVP), also known as the Green Light Laser, has emerged as the treatment of choice for most patients having surgery for BPH. It is minimally invasive in the sense that all the work to open the prostate channel is made through the penis, without an incision on the abdomen. The obstructive prostate tissue is vaporized by the directed laser beam. This is done under spinal or general anesthesia. The advantages of this approach over the traditional TURP (transurethral resection of the prostate) are many:
- PVP is done on an outpatient basis
- Blood loss is virtually nothing
- Patients live with a urinary catheter postop for only one day
- The irrigant used is much less likely to cause electrolyte abnormalities
The downside to PVP is that no prostatic tissue is collected for microscopic review. An occult prostate cancer would be missed. Considering that patients are screened prior to PVP with rectal examination and PSA check, it is not likely that a prostate cancer will be missed, nor is it likely that a missed cancer will be significant. Also, some patients develop irritative voiding symptoms (urgency or frequency of urination) immediately following PVP, though this typically abates in time.