PVP (Photoselective Vaporization of Prostate)

What is a Photoselective Vaporization of Prostate (PVP)?

Photoselective vaporization of the prostate (PVP) is a form of laser therapy used to remove all or part of the prostate gland.  It is used to treat benign prostatic hyperplasia (BPH), a non-cancerous growth or enlargement of the prostate gland.

How is it done?

PVP is performed under local, spinal or general anesthesia and takes between 20 and 50 minutes. A very large prostate may take longer time.  During the procedure, the surgeon will use tube called an endoscope to deliver the laser to the prostate vaporizing any excess tissue.  Some patients will be required to be catheterized for up to 24 hours after surgery.

 Why is it done?

PVP is recommended for patients who has urination symptoms resulting from benign prostatic enlargement such as inability to urinate; bleeding through the urethra; kidney damage caused by urine backing up; frequent urinary tract infections; or stones in the bladder. For symptoms like :-  poor urination, frequency of urination , night time urination more than two times/night , the doctor will consider if the severity of the symptoms warrants surgery or not.

 Risks & complications

Complications are infrequent and usually minor. There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include the possibility of:

-  Small amount of blood in urine

-  Mild irritation or urinary frequency for short  period of time
-  Emptying of semen into the bladder instead of out of the urethra (called retrograde ejaculation, or ‘dry’ orgasm)

Some patients may experience bleeding and blood in the urine for several weeks after surgery.  Risks can be reduced by following the surgeon's instructions before and after surgery.

 Alternatives

The surgeon may discuss alternative approaches to PVP laser treatment.  Some medicines can improve the flow of urine or shrink the prostate.  A short tube (called a stent) can be inserted into the urethra to improve urine flow. Saw palmetto extract is one of several herbal remedies that may be helpful. Heat therapy using microwaves, ultrasound or electric current instead of lasers can be used to destroy excess prostate tissue.  If symptoms are not troublesome, some men choose not to have any treatment.  Symptoms do not always worsen over time and can sometimes improve without treatment.

 Candidate eligibility

The best candidates for Photoselective Vaporization of Prostate (PVP) are men with moderate to severe symptoms (i.e., bladder obstruction) caused by prostate enlargement either or not responded to proactive medical therapies. Patients with prostates of a combined volume of more than approximately 250cm3 may not be candidates for PVP or other transurethral procedures. More invasive surgical techniques may be required. The urologist will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient.