BPH

[wisahickoner]

Does anyone know of a resource that actually compares the efficacy of different laser therapies ? My Doc has suggested Indigo laser but there is very little on the internet about this and it is no longer manufactured by J & J( I don't know why but could it be that it does not work very well?). The 'Green Light Laser' seems to very popular now.
I am getting the impression that the Docs will recommend the Laser that they have in their office rather than send you to a different Doc with a different laser which might work better.

[ziggy22]

My doctor also uses the Indigo laser and I'm scheduled for the procedure at the end of February. From what I understand the Indigo laser destroys small amounts of prostate tissue, which is then excreted by absorption or through the urethra. The Greenlight laser, I believe, is hotter and can destroy and vaporize prostate tissue.
What concerns me about the Indigo laser is the prostate's ability to expel the destroyed tissue. The more invasive procedure, TURP, requires a hospital stay but involves surgical removal of small pieces of the prostate through the urethra.
Are there any in this forum with information about the different laser treatments?

[wisahickoner]

I agree with your concern about the Indigo laser, it worries me also. My Doc has stated categorically that it 'may or may not work', this is hardly conducive to undergoing the procedure which is why I am researching the other options.I have read that the Greeen light laser is very similiar in efficacy to a TURP procedure except that that it is minimally invasive,does not require a hospital stay, catheterisation is drastically reduced and the risk of impotence/RE is also much less.Another disadvantage of Indigo seems to be that if it does work it takes 3-4 months to kick in, presumably as the tissue is gradually absorbed.Both TURP and green light laser appear to be immediately effective.

FYI:If you type in 'prostate laser' on 'You tube' you can actually watch a green light and a TURP procedure, ouch .The videos make it quite clear why both these procedures are immediately effective.

[morg21279]

I flew to Florida to have the Green Light procedure with Dr. Lin in St. Augustine about 3 1/2 weeks ago. Had a catheter for about 7 hours, and went back to the hotel with minimal discomfort and bleeding. Had a bit of urethra trauma taking the catheter out, which caused a slightly longer recovery time, but flew home and was back into a pretty normal lifestyle (no straining/lifting) within a few days. I took a nice 10 mile bike ride yesterday. Life is good.

I think the Green Light is the best procedure, but the real key is to find a great surgeon. Great tools in inexperienced, or less gifted hands can still give bad results.

[wisahickoner]

I just saw another Dr for a 2nd opinion on the Indigo laser.He confirmed my impression that Indigo is very old technology and absolutely did not recommend it.After doing an ultrasound He recommended Green light for me although he has the capability to do some of the other options(eg TUMT).
I will almost certainly go for the green light. He did say he always kept his patints in the hospital overnight as a precaution but that is not so bad.

[ziggy22]

I cancelled my scheduled Indigo laser treatment and will continue using Flomax until I go for the Green Light laser treatment. Should you have that procedure perhaps you would let this forum know of your experience.

[wisahickoner]

I had the green light on Feb 7th.It turns out that my problem was more complicated than usual in that the Dr had to also do some cutting in addition to the laser. My Dr insists that all patients say in hospital overnight and then does let you leave until he knows you can urinate after the catheter has been removed ( I had the procedure at 11am and the catheter was removed at 6am the next day).
The entire procedure was more of an ordeal than i had anticipated; because most Drs talk about catheterisation for a few hours and then home you go, i was treating it like a tooth extraction rather than the surgery it is.
Concernin g the results , I have been told that it may take several more weeks for the inflammation ( caused by the laser) to subside .Right now I do not know what the final result will be, what is very clear is that when I go to urinate I go immediately, it used to take me forever to start but now I have no fear .The anxiety that I used to feel about having to go the emergency room to be catheterised is gone.The main problem I have had is irritation/urgency although in the last 3 days this has improved a lot.I have been taking the flomax on and off and also an NSAID to work on the inflammation .The Dr says I should be able to get off the Flomax as soon as the irritation disappears.The Dr also says that some men get an immediate 'spectacular' improvement or cure and others such as me have to wait longer.For 2-3 weeks after the surgery I had some very minor bleeding.
So ,in short I do not yet know the final outcome but everything seems to be going in the right direction but slowly.I was at the Dr last Friday and he showed me that my residual volume after urination was miniscule compared to that before the surgery.He thinks I am going ot be very pleased but I have to give the prostate time to heal from what is a fairly brutal assault.
I am glad I had the procedure and hope that over the next few weeks the irritation/inflammation will subside and my frequency will subside with it.
I am happy to answer any other questions.

Good Luck

[ziggy22]

Thank-you for letting us know of your experience with the Green Light Laser. I'm happy that all went well. As you pointed out, the prostate has to heal and it will be several weeks before you experience the desired effect of the procedure. Again, thank-you for your informative post.

[Planetoid]

I had the PVP procedure about a week ago. Had used various and combinations of meds for the last eight years, with various and usually temporary results. Multiple cystos and one negative biopsy. Decided I wanted to get off the meds, so talked with uro about other options. He recommended the PVP, and after 8 months of vasilating, I finally made the decision and scheduled the procedure. Note that at least in my case, the uro was prepared to perform a traditional TURP, should the laser equipment fail during the procedure, and I concurred with that track. Had a spinal; procedure took about 40 minutes, two hours in recovery, and moved to an amubulatory procedures unit overnight. Had foley cath removed early next morning, and after providing several void volumes and matching Post Void Residual (PVR) scans to ensure I was emptying, I was discharged about 24 hours after my arrival. Most painful aspects were removal of the cath, and then removal of the IV cath from my arm (too much tape and too much hair, well at least there was). Offered pain meds, but never took anything more than acetaminophen (Tylonol) post op, and that was more as an anti-inflamatory. Had some poor voiding issues before the weekend, but now doing well.

[bigprostate]

You are correct. Each urologist will recommend the procedure that he uses. I strongly recommend getting several opinions.