Bladder Pain Syndrome

Prostate Enlargement Treatment with ‘GREENLIGHT’

As men age, the prostate is the only organ that does not experience a decrease in cellular, tissue, and physical size. Responsible for creating conditions necessary for sperm since adolescence, the prostate begins to enlarge after the age of 40, causing bothersome urinary symptoms such as difficulty urinating due to narrowing of the urethra it surrounds, increased frequency of urination both during the day and at night.

Currently, medication or surgical treatments are used for the treatment of benign prostatic hyperplasia (BPH). Medications are broadly categorized into two groups. The first group of drugs only alleviates patients’ symptoms, requiring lifelong use to prevent symptoms from recurring. The second group of drugs, although reducing the size of the prostate gland, is limited in efficacy, usually achieving around 20% reduction. Medications are used to alleviate the symptoms of patients who do not require definitive surgery, those who prefer non-surgical treatment, or those unable to undergo surgery due to other diseases.

In surgical treatments, the primary goal is to eliminate the part of the prostate causing difficulty in urination. With technological advancements, the most effective and least damaging surgical options are preferred. Destroying prostate tissue using laser energy is one of these options.

Here are some brief details about GREENLIGHT, one of the laser energy sources used:

Due to the intense sensitivity of laser energy to hemoglobin in blood cells, there is no bleeding during the procedure. This feature allows its use in patients taking blood thinners. Since laser beams penetrate only 1-2 mm deep, their effect is controlled, and they do not cause widespread damage beneath the vaporized area, ensuring safety. Therefore, postoperative erectile dysfunction is not observed. It can be applied with various anesthesia options, ranging from local anesthesia to general anesthesia, making it an important alternative for high-risk patients with general health problems who require surgery. The safety of the Greenlight laser system is approved by the Food and Drug Administration (FDA) in the United States, which regulates the use of medical devices. Compared to other surgical options, the recovery time for catheterization and return to daily activities is shorter after Greenlight treatment. The catheter is usually removed within 24 hours in most patients. A significant improvement in urine flow is observed in most patients after the catheter is removed. However, recovery is a process, and more meaningful improvement in urinary symptoms will occur over time. After catheter removal, it is normal to experience a burning sensation during urination and see some blood in the urine. Avoiding heavy activities (running, lifting heavy objects, biking, etc.) for 2 weeks and abstaining from sexual intercourse for 4 weeks is recommended after the operation. As in all prostate surgeries, retrograde ejaculation, where semen enters the bladder during ejaculation, may occur after Greenlight treatment. One disadvantage of Greenlight applications is the inability to obtain tissue for pathological evaluation. Since the treatment of prostate cancer is very different, it is essential to rule out the possibility of prostate cancer before the procedure.

Effective evaluation, accurate differential diagnosis, and individualized treatment selection are crucial in the treatment of prostate enlargement. A well-informed patient, guided by the responsible physician, can easily decide on the most appropriate treatment method for themselves.