GreenLight Laser Prostate Vaporization: Post-Operative Concerns

GreenLight Laser Prostate Vaporization

My father underwent GreenLight laser prostate vaporization surgery at the end of 2005.
In October 2010, he experienced severe hematuria due to benign prostatic hyperplasia and underwent the GreenLight laser prostate vaporization surgery again at the end of November.
However, nearly a month after the surgery, he still has microscopic hematuria and experiences a sensation of incomplete bladder emptying.
Additionally, his nocturia has worsened (before the surgery, he would wake up twice a night; now it is four times).
Is this normal? My father regularly takes aspirin, but he stopped taking it two weeks before the surgery, and it has been nearly a month since the operation.
The doctor advised us not to resume taking it to avoid the risk of significant bleeding.
I am quite confused as to why, after spending 150,000 NTD on this surgery, which is widely touted as safe with quick recovery and minimal bleeding, the results are not meeting our expectations.
Could you please help clarify our concerns? Thank you.

Xiao Di, 40~49 year old female. Ask Date: 2010/12/26

Dr. Lin Yiting reply Urology

Any surgery involving the urethra, prostate, and bladder may result in microscopic hematuria, as well as increased urinary frequency and nocturia during the wound healing period, which typically lasts about 1-2 months postoperatively.
Generally, these symptoms improve within two months.
If hematuria and urinary frequency do not improve after an extended period, further investigation into the cause of hematuria is necessary.
Aspirin can usually be taken after microscopic hematuria resolves, but the decision to discontinue aspirin should be assessed by the original prescribing physician to evaluate the risks of discontinuation.
Traditional surgeries often result in visible hematuria within 1 to 2 months postoperatively, and there is a significant amount of bleeding during the procedure.
Additionally, there is a risk of water intoxication, which can lead to rhabdomyolysis, hemolysis, and renal failure, making it quite challenging to manage.
GreenLight laser surgery successfully avoids these various complications and is currently considered a highly safe surgical option.

Reply Date: 2010/12/26

More Info

The situation you described regarding your father's experience with GreenLight Laser Prostate Vaporization raises several important considerations about post-operative recovery and potential complications. First, it's essential to understand that while GreenLight Laser surgery is generally regarded as a minimally invasive procedure with a relatively quick recovery time, individual outcomes can vary significantly based on various factors, including the patient's overall health, the severity of the prostate condition, and any pre-existing medical conditions.

Post-Operative Concerns
1. Persistent Hematuria (Blood in Urine):
- It is not uncommon for patients to experience some degree of hematuria following prostate surgery, especially within the first few weeks post-operation. However, if your father is experiencing blood in the urine nearly a month after the procedure, it warrants further investigation. Factors that could contribute to prolonged bleeding include irritation of the urinary tract, residual blood from the surgery, or even the presence of blood clots. It is crucial to follow up with the urologist to rule out any complications.

2. Urinary Retention and Incomplete Emptying:
- The sensation of not being able to empty the bladder completely can occur after prostate surgery due to swelling or changes in the anatomy of the urinary tract. This can lead to increased frequency of urination, particularly at night (nocturia). If your father is experiencing significant discomfort or if this issue persists, it may be necessary to evaluate for potential urinary retention or obstruction.

3. Increased Nocturia:
- The increase in nighttime urination from two to four times can be attributed to several factors, including the surgery itself, changes in bladder function, or even the psychological impact of the surgery. It is essential to monitor this symptom and discuss it with the healthcare provider, as it may require further management or intervention.

Medication Considerations
- Aspirin and Bleeding Risks:
- The decision to stop aspirin prior to surgery was appropriate, as it can increase the risk of bleeding. However, the timeline for resuming aspirin should be guided by the urologist based on your father's recovery and any ongoing bleeding issues. It's crucial to communicate any concerns about medication management with the healthcare provider.

Expectations and Follow-Up
- Understanding Surgical Outcomes:
- While GreenLight Laser surgery is marketed as a safe and effective treatment for benign prostatic hyperplasia (BPH), individual results can vary. Factors such as the size of the prostate, the presence of other medical conditions, and the patient's overall health can influence the outcome. It is essential to have realistic expectations and to understand that some patients may require additional treatments or interventions if symptoms persist.

- Importance of Follow-Up Appointments:
- Regular follow-up appointments are critical for monitoring recovery and addressing any complications. If your father continues to experience symptoms such as hematuria, urinary retention, or increased nocturia, it is vital to communicate these issues to the healthcare provider. They may recommend imaging studies, additional tests, or even further interventions to ensure optimal recovery.

Conclusion
In summary, while your father's experience with GreenLight Laser Prostate Vaporization may not align with the expected outcomes, it is essential to maintain open communication with the healthcare provider. Persistent symptoms should be thoroughly evaluated to rule out complications and to determine the best course of action. Encourage your father to attend all follow-up appointments and to discuss any ongoing concerns with his urologist to ensure a comprehensive approach to his recovery.

Similar Q&A

Understanding Green Light Laser Treatment for Enlarged Prostate: Risks and Benefits

Hello Doctor: My family lives in Changhua. My father has been experiencing urinary difficulties for the past few years, and an ultrasound revealed symptoms of benign prostatic hyperplasia (BPH). I have heard about the latest technology, green light laser therapy, for vaporizing a...

Dr. Lai Ronghao reply Urology
Hello: The cost of green light laser surgery is approximately 150,000 TWD. It is claimed to have fewer postoperative complications, less erectile dysfunction, and less urinary incontinence. Our hospital does not perform this surgery, but there are several hospitals in Taipei that...

Prostate Surgery Options for Patients with Poor Lung Function

Hello, Director. My father is about 90 years old and has severe chronic obstructive pulmonary disease (COPD) and benign prostatic hyperplasia (BPH). He has been using a urinary bag for nearly five months, with repeated insertions and removals. Recently, he experienced his second ...

Dr. Du Shixi reply Urology
Hello: Currently, only a few hospitals perform prostate artery embolization. Laser treatment still requires anesthesia, which carries less risk than traditional surgery, but it is not without risks. Older individuals often have compromised systems and may experience slower recove...

Post-Prostate Laser Surgery: Understanding Persistent Urination Pain

Dear Dr. Zhou, Hello. My father is currently 74 years old. At the end of last year, he suffered from frequent urination, difficulty urinating, and hematuria, which led him to undergo laser vaporization surgery for prostate issues in February of this year. It has now been three m...

Dr. Zhou Xinpei reply Urology
Hello: Regarding the issue you inquired about, although the urinalysis results are normal, there is still a condition of painful urination. It is recommended to further consult a urologist and arrange for more invasive examinations, such as cystoscopy, to clarify the underlying p...

Is Minimally Invasive Prostate Vaporization Safer Than Other Treatments?

Is the minimally invasive water vapor ablation for the prostate safer compared to other prostate surgeries? What are the risks associated with water vapor ablation?

Dr. Du Shixi reply Urology
Hello: In my opinion, the biggest drawback of the developing surgery is that the catheter is placed for more than a week. As for safety, there is not much difference among the various surgeries; as long as there are no issues with anesthesia, they are all quite safe. Wishing you ...