Health Matters - London Bridge Hospital

GreenLightGreenLightAn average GP practice with 2000 patients will have approximately150 men registered with urinary symptoms severe enough toconsider seeking treatment at some point in time.Traditionally, the successful management ofsymptomatic Benign Prostatic Hypertrophy(BPH) has been Transurethral Resection ofthe Prostate (TURP), which was viewed byboth surgeons and General Practitioners asthe gold standard procedure, given its provenefficiency and long-term durability.When the GreenLight PVP laser therapywas introduced to the UK five years agoby Consultant Urological Surgeon, MrGordon Muir, the laser technique not onlydemonstrated comparable advantages tothose of TURP, but also highlighted theunique benefits of being a daycase, withreduced blood loss, few complications(if any) and minimal morbidity.In 2004, the GreenLight laser procedureat King’s College Hospital received the UKClinical Excellence Award for Innovation,soon followed by the approval of theNational Institute for Health and ClinicalExcellence (NICE). Today, more than 1000urologists over 30 countries, (many trainedby Mr Muir), perform the minimal invasiveoperation and over 150,000 patients havesuccessfully been treated.In January this year, Executive Director, JohnReay, decided to equip the hospital with themost advanced model of the GreenLight, theGreenLight HPS, with a view to providing hispatients with a laser surgical alternative toTURP, that had proven comparable benefits.Mr Gordon Muir, who has performed over1000 GreenLight operations and who wasthe first surgeon in Europe to use the HPS,confirmed over 95% success rate in men withcatheters for retention of urine, thanks to thenew technology and reported overall excellentresults from a surgical perspective, coupledwith very positive patient feedback.Mr Muir also observed that the HPS definitelysped up the process of removing obstructingprostate tissue, allowed more precision whencompared with its predecessor, reduced timeunder anaesthesia and, ultimately, increasedsafety for patients.What is the GreenLight laser?The GreenLight PVP technology releaseshigh powered laser energy into the cells bymeans of continuous saline irrigation, whichis then absorbed by tissue and haemoglobin,leading to a rapid heating of cells andvaporisation of tissue.Similarities with TURP• Greater than 100% improvement in urinaryflow rates• Over 50% decrease in symptoms• Spontaneous voiding for patients withurinary retention• Immediate removal of the prostatic bladderoutlet obstruction• Comparable operative time• Proven capabilityLong-term durabilityObservations of the GreenLight PVP duringclinical studies concluded to the durablecapability of the procedure and its long-termoutcomes, with significant improvements inmaximum urinary flow rate. 4-5 year followupfrom a number of International centres,including ours, suggests positive durable results.Advantages over TURPClinical studies have shown a low risk ofmainly minor adverse events. TURP can beaccompanied by risks of postoperative urinaryretention, infection, incontinence, erectiledysfunction, impotence, blood transfusion,capsular perforation, clot retention.With the GreenLight laser therapy, the risksof serious bleeding, TUR Syndrome anderectile dysfunction are close to nil. Economicstudies have highlighted the benefits of theGreenLight, in terms of in-hospital costs, andmostly, patients are able to return to normalactivity very rapidly.Large ProstatesTraditionally, open prostatectomy was theoperation of choice for patients with largeprostates, due to the relative inability ofTURP to resect larger glands over 80-100mldue to the risks of TUR Syndrome andsevere bleeding. Since then, the GreenLightlaser therapy has proved to be a very safeoption in treating these large prostates, andmany of these patients can even be treatedin a daycase setting.TUR SyndromeTURP carries a significant risk of absorbingthe irrigating fluid that may cause pulmonaryand cerebral oedema, in extreme casesleading to ITU treatment. Our research onthe GreenLight laser has shown that thispotential complication is abolished.High Risk PatientsFor patients on anticoagulant therapies, withbleeding disorders or at risk of cardiovascularco-morbidity, the GreenLight laser procedureoffers a reasonable surgical alternative due toits haemostatic nature, significantly decreasingthe risks of bleeding, clot retention, transfusion,sometimes seen with TURP.Patient Benefits• Immediate symptom relief• Rapid flow rate improvement• Fast recovery times• Daycase procedure with somepatients resuming work thefollowing dayPatient Programme andOnline CPD WorkshopGeneral Practitioners wishing to illustratethe procedure to their patients can requesta free patient information CD.We understand the importance ofContinuing Professional Development andas such, we are also offering an onlineworkshop for the GreenLight procedure.To obtain details on eitheroption simply call us on:07738 287764101 GreenLight is a trademark of American Medical Systems Inc. 2 Mr Gordon Muir is an International Mentor for the GreenLight procedure and a member of the Renaissance Healthcare Group.3 Based on short-terms results since 2002. 4 Data presented at the European, American and British Annual Urological Meetings, and published in a number of international journals.