PROSTATE ENLARGEMENT TREATMENT WITH ‘GREENLIGHT’

In aging men, while most organs experience cellular, tissue, and physical shrinkage, the prostate is the only organ that expands. Prostate, responsible for creating the necessary conditions for sperm since adolescence, starts to enlarge around the age of 40, narrowing the surrounding urethra and causing bothersome urinary symptoms such as difficulty urinating, increased frequency of urination at night and/or during the day.

Currently, medication or surgical treatments are used for the treatment of benign prostate enlargement. Medications are roughly divided into two groups. The first group of drugs only alleviates patients’ symptoms. Since symptoms will recur when the medication is not used, and it requires lifelong use. The other group of drugs, while reducing the size of the prostate gland, is limited in effectiveness as the reduction is around 20%. Nowadays, medication treatments are used to reduce the symptoms of patients who do not necessarily need surgery, do not prefer surgical treatment, or cannot undergo surgery due to other illnesses.

In surgical treatments, the main goal is to eliminate the part of the prostate that causes difficulty in urination. In this regard, the most effective and least harmful surgical options compatible with technological developments are preferred. One of these options is the destruction of prostate tissue using laser energy.

Here are brief details about the GREENLIGHT laser energy source:

• Due to the intense sensitivity of laser energy to hemoglobin in blood cells, there is no bleeding during the procedure. With this feature, it can be used in patients using blood thinners.
• Since laser beams penetrate 1-2 mm deep, their effect is controlled, and their safety is ensured as they do not cause extensive damage beneath the evaporating area. Therefore, there is no erectile problem after the operation.
• It can be applied with various anesthesia options, from local anesthesia to general anesthesia, making it an important alternative for high-risk patients with a general condition that requires surgery.
• The safety of the Greenlight laser system has been approved by the Food and Drug Administration (FDA), the organization overseeing the use of medical devices in the United States.
• Compared to other surgical options, the duration of catheterization and the return to daily activities is shorter after Greenlight. The catheter is usually removed within 24 hours in most patients.
• There is a significant improvement in urine flow in most patients after the removal of the catheter. However, recovery is a process after surgical interventions, and more meaningful improvement in urination complaints will occur over time.
• After the removal of the catheter, burning sensation during urination and a small amount of blood in the urine are normal.
• It is recommended to avoid heavy activities (running, lifting heavy weights, cycling, etc.) for 2 weeks after the operation and to refrain from sexual intercourse for 4 weeks.
• As in all prostate surgeries, retrograde ejaculation (entry of semen into the bladder during ejaculation) may occur during ejaculation.
• The disadvantage of Greenlight applications is that tissue cannot be obtained for pathological evaluation. Since the treatment of prostate cancer is very different, it is necessary to rule out the possibility of prostate cancer before the application.

In the treatment of prostate enlargement, a good evaluation, accurate differential diagnosis, and the individualization of the selected treatment method are important. A center where the patient is evaluated and can go for a differential diagnosis and where different treatment methods can be applied positively affects patient satisfaction and the results obtained. A well-informed patient about the disease and treatment methods, guided by the responsible physician for their treatment, can easily make a decision about the most suitable treatment method for themselves.