GreenLight laser prostate surgery, usually called photoselective vaporisation of the prostate (PVP), uses a 532-nm laser to vaporise obstructing benign tissue through the urethra. In appropriately selected men, particularly with prostates around 30-80 mL, it can provide symptom and flow improvement comparable with TURP while often reducing perioperative bleeding, catheter time and hospital stay. It is not reliably ejaculation-preserving, and retreatment may be higher than after TURP or enucleation in some long-term datasets, especially as prostate size increases.

What is GreenLight Laser Prostate Surgery Explained?

The GreenLight laser is strongly absorbed by haemoglobin. This allows the surgeon to vaporise prostate tissue while simultaneously producing haemostasis. Modern systems commonly use higher-power platforms such as 180 W XPS.

PVP removes the obstructing inner prostate by vaporisation rather than cutting chips with an electrical loop. It should not be confused with laser enucleation, where the adenoma is anatomically shelled out.

Who may be suitable?

The procedure should be chosen after confirming that the symptoms are genuinely related to benign prostate obstruction rather than infection, urethral narrowing, bladder disease or a weak bladder alone.

• Moderate-to-severe BPH symptoms that need operative treatment.
• Patients in whom reduced bleeding is particularly desirable after an individual review of antiplatelet or anticoagulant medicines.
• Men who want a transurethral tissue-removing procedure with a relatively short catheter and hospital stay.
• Prostates within a size range suitable for efficient vaporisation by the treating surgeon.
• Patients who accept that retrograde ejaculation is common after tissue-removing prostate surgery.

When may another treatment be better?

• Very large glands where anatomical enucleation may remove tissue more efficiently and durably.
• A patient whose highest priority is preserving antegrade ejaculation.
• Suspected bladder weakness without proven obstruction.
• Need for a sizeable prostate tissue specimen when histological assessment is especially important.
• Centres without contemporary GreenLight equipment or sufficient procedural experience.

How is the procedure done?

A telescope is passed through the urethra under anaesthesia. The laser fibre is moved across the obstructing lobes, vaporising tissue until a wide channel is created from the bladder neck to the verumontanum. Bleeding points are treated with the laser.

No external incision is made. A urinary catheter is usually placed at the end of the procedure.

Anaesthesia and hospital stay

GreenLight PVP is commonly done under spinal or general anaesthesia. Many patients have a short admission and some centres perform selected cases as day surgery.

Will I need a catheter?

A catheter is normally used overnight or for a short period. Retention, significant swelling, bleeding or a large preoperative residual can make a longer catheter period necessary.

Potential benefits

• Effective improvement in urinary symptoms and flow.
• Less perioperative bleeding and transfusion than monopolar TURP in many studies.
• Often shorter catheterisation and hospital stay.
• Useful option in selected patients with increased bleeding risk after careful medication planning.

Important limitations

• Retrograde ejaculation remains common and is not clearly lower than TURP.
• Very large prostates may take longer to vaporise and may have higher retreatment risk than enucleation.
• Long-term reintervention has been higher than TURP in some real-world datasets.
• Vaporised tissue does not provide the same pathology specimen as a TURP or HoLEP specimen.

Recovery after treatment

Mild burning, urinary frequency and visible blood are common early after GreenLight surgery. BAUS patient information notes that irritative symptoms occur in most patients initially. Urine may become pink again after activity as the healing surface sheds.

Most men can return to desk-type work before they return to heavy physical work. Strenuous exercise, heavy lifting, cycling and sex are generally delayed until bleeding has settled and the surgeon confirms recovery is progressing normally.

Erections and ejaculation

GreenLight surgery usually preserves erections, but ejaculation often changes because the bladder neck and prostatic channel have been opened. Retrograde ejaculation means semen travels into the bladder rather than out through the penis. This is not harmful, but it can matter to fertility and sexual expectations.

Risks and side effects

• Temporary burning, frequency, urgency and blood in the urine.
• Retrograde or absent external ejaculation.
• Urinary infection.
• Temporary urinary retention after catheter removal.
• Urethral stricture or bladder-neck contracture.
• Temporary leakage; persistent incontinence is uncommon.
• Bleeding requiring irrigation, reoperation or transfusion is possible but generally less common than with conventional resection.
• Future retreatment for recurrent obstruction.

What to bring for consultation

• Ultrasound report showing prostate volume and post-void residual urine.
• Uroflowmetry result if available.
• Urine routine/culture and serum creatinine.
• PSA report when it has been advised as part of your prostate assessment.
• A list of prostate medicines, blood thinners and other regular medicines.
• Records of previous retention, catheterisation or prostate/urethral procedures.

FAQs

Related reading

• TURP Surgery for Enlarged Prostate
• HoLEP Surgery for Enlarged Prostate
• Which Prostate Surgery Is Best for Me? TURP, HoLEP or Other Options
• Which Prostate Treatments Can Preserve Ejaculation?
• Burning and Frequent Urination After TURP or HoLEP
• Urologist in Latur

References

• European Association of Urology. EAU Guidelines on the Management of Non-neurogenic Male LUTS: Disease Management, 2026 https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts/chapter/disease-management
• American Urological Association. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia Guideline https://www.auanet.org/guidelines-and-quality/guidelines/bph-guideline
• British Association of Urological Surgeons. Prostate procedures: patient information https://www.baus.org.uk/patients/information_leaflets/category/8/prostate_procedures