Frequently Asked Questions

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• What is the prostate?

The prostate is part of the male reproductive system. The main function of the prostate is to produce ejaculatory fluid. The prostate is the size of a walnut and is located below the bladder and in front of the rectum, surrounding the urethra, the tube-like structure that carries urine from the bladder out through the penis.

• What is BPH?

Benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland that affects men over the age of 50. As the prostate enlarges, it can squeeze down on the urethra like a clamp on a garden hose, resulting in urinary difficulties.

• What are some of the risk factors for BPH?

Risk factors for developing BPH include increasing age and a family history of BPH.

• What are some of the symptoms associated with BPH?

Common symptoms include a frequent and urgent need to urinate, sometimes as often as every two hours or more, especially at night. Other symptoms include the sensation that the bladder doesn't completely empty, dribbling and leaking or pain during urination. In extreme cases, a man might not be able to urinate at all, which is an emergency that requires prompt attention.

• How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. This series of questions helps to measure how severe the BPH is - ranging from mild to severe.

When a doctor evaluates someone for possible BPH, the evaluation will typically consist of a thorough medical history, a physical examination (including a digital rectal exam or DRE), and use of the AUA BPH Symptom Score Index. In addition, the doctor will generally do a urine test called a urinalysis. There are a series of other studies that may or may not be offered to a patient being evaluated for BPH depending on the clinical situation. These include:

1.	prostate specific antigen (PSA), a blood test to screen for prostate cancer
2.	urinary cytology, a urine test to screen for bladder cancer
3.	a measurement of post-void residual volume (PVR), the amount of urine left in the bladder after urinating
4.	uroflowmetry, or urine flow study, a measure of how fast urine flows when a man urinates
5.	cystoscopy, a direct look in the urethra and/or bladder using a small flexible scope
6.	urodynamic pressure-flow study that tests the pressures inside the bladder during urination
7.	ultrasound of the kidney or the prostate

When should I see a doctor about BPH?

If you are experiencing any of these urinary symptoms you should see a doctor. If you you have blood in your urine, pain with urination, burning with urination or are unable to urinate, you should immediately see your physician.

Does BPH lead to prostate cancer?

No, BPH is not cancer and cannot lead to cancer, although both conditions can exist together. There are usually no symptoms during the early stages of prostate cancer, and so yearly physical examinations and PSA tests are highly recommended to eliminate cancer diagnosis.

Which type of drugs are the best?

To date, there is not enough research data to predict who will respond to medical therapy or which drug will be better for an individual patient.

How do I know if oral medications are the best treatment for me?

If you are diagnosed with BPH, you should discuss all treatment options with your urologist. Together, you can decide whether medication or surgical treatment is best for you. Often times medical treatment merely delays surgical treatment. If you are currently taking medication for your BPH but your symptoms have returned or worsened, you should consult your physician about alternative treatments.

Are minimally invasive heat treatments a long term solution?

There is not enough data to predict who will respond favorably to heat treatments or enough data to determine how lasting the treatment will be.

Are all laser treatments the same?

No. Laser treatments can vary significantly depending upon many factors. Different lasers operate at different wavelengths or color. The color of the laser energy determines the affect on tissue, how quickly and efficiently it is transmitted and how deep it can penetrate into the tissue. Other important factors are a patients health, size of prostate gland and other medications the patient may be taking.

Why is the PVP Procedure using the GreenLight PV™ Laser System recommended over other laser treatments?

The GreenLight laser emits a green laser light to quickly vaporize prostate tissue and create an immediate open channel for urine to pass through. GreenLight is the preferred energy source because the green laser light is highly attracted to the vascular, red tissue of the prostate. The green laser beam is so safe, patients with very large glands, patients in frail health and patients taking anti-coagulant medication can be treated.

• Is the GreenLight PV Laser System FDA approved for performing PVP Procedures?

Yes, the GreenLight PV Laser System received FDA clearance in May 2001.

• How many PVP procedures have been performed using the GreenLight PV™ Laser System ?

More than 90,000 patients have been treated with the GreenLight PV Laser over the past three years.

• Is the procedure covered by insurance?

Yes, the PVP procedure is covered by Medicare and by most private insurance plans.

• How does the GreenLight laser work?

A thin fiber is inserted into the urethra through a cystoscope. The fiber delivers green laser energy that quickly vaporizes and precisely removes enlarged prostate tissue. The physician is able to safely view and control the treatment area, tailoring it to your individual anatomy and needs. Natural urine flow is immediately restored and urinary symptoms are relieved quickly..

• Where is the PVP procedure performed?

PVP is usually performed in a hospital or an ambulatory surgery center. Patients may be released after a few hours or after an overnight stay.

• Will I have to spend the night in the hospital?

Most patients can go home a few hours after the procedure. Although some patients will spend a night in the hospital and go home the following morning, particularly if the procedure is done late in the day, or if you have traveled a long distance to reach the hospital.

• Will I need anesthesia?

You will need anesthesia of some type for the PVP procedure. Depending upon your medical condition, the doctor may use general or spinal anesthesia, or block the nerves to your prostate using a local anesthetic, and a light IV (intravenous) sedation.

• Will I experience pain during the procedure?

Patients have not reported any pain during the procedure. You and your doctor will discuss appropriate pain medication.

• Will I need to wear a catheter?

Many patients do not need a catheter. If one is required, it is usually removed in less than 24 hours.

• What are the risks or complications?

There are a few risks with the PVP procedure. Most patients report a very high level of satisfaction. Patients my experience sligh burning during urination and /or a little bit of blood in the urine for a couple of weeks. Some men may experience more severe symptoms, which can be treated by your urologist. Retrograde ejaculation, or "dry climax" may occur.

• What are the risks of infection after the procedure?

Since catheterization time after PVP is very short, the risk of urinary tract infections is rare.

The laser energy for the PVP procedure is transmitted through a fiber optic, which is a single use device. Make sure your procedure is performed with a new, unused fiber to avoid the transmission of potential life threatening diseases.

• Will I experience pain after the procedure?

After the procedure you may have some mild discomfort such as slight burning during urination for a week or so. This can be managed with mild pain medications and anti-inflammatory drugs

• How long before I see results?

Many patients obtain immediate or very fast relief of symptoms and a dramatic improvement in urine flow usually within 24 hours of the procedure.

• How soon can I return to normal activities?

Most patients can resume normal activities like driving a car or working a desk job within the week.

• What are the side effects, risks and complications of PVP?

The PVP procedure is generally considered to be very safe. Most patients report a very high level of satisfaction. Patients may experience slight burning during urination and/or a little bit of blood in the urine for a couple of weeks. Some men may experience more severe symptoms, which can be treated by your doctor. Retrograde ejaculation, or “dry climax” following treatment may occur. According to published clinical studies, there have been no reports of loss of bladder function (incontinence); loss of sexual ability (erectile dysfunction); have required a blood transfusion, suffered TUR-Syndrome, or death.

• Will there be any sexual side effects?

The PVP Procedure should not affect your ability to have an erection or an orgasm. No case of erectile dysfunction due to the PVP procedure has even been reported in over 20 published clinical studies. Retrograde ejaculation, or “dry climax” may occur. If you are sexually active now, you can look forward to remaining so.

• Can I have PVP if I have failed other BPH treatments such as TUNA, TUMT, ILC, or WIT?

Yes, many patients who have failed these treatments have been successfully treated with PVP. Consult your urologist to find out if PVP is right for you.

• Can I have PVP if I had a TURP?

Yes. As a general rule, if you are a suitable candidate for TURP, you can be considered a good candidate for PVP. Consult your urologist to find out if PVP is right for you.

• Will I still need to take my prostate medication following the PVP procedure?

No. Your doctor will tell you when you can stop taking these medications.

• How do I know if I am a candidate for PVP?

Only your urologist can determine if you are a candidate, based upon your history & physical examination, as well as his clinical judgement.

• How long can I expect the effects of the procedure to last?

Published clinical studies show that the procedure is lasting through five years. Data beyond that point is not yet available. Very few patients require re-treatment.

• How can I learn more about PVP?

Please consult your urologist for more detailed information and risks. As with any medical procedure individual results will vary. The statements on this website are based on typical clinical study outcomes.

• Where can I go to have the PVP Procedure performed?

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