This type of surgery is especially useful for men who are on blood thinning tablets or men who are taking anti-coagulation drugs. This is because there is very little blood loss as the blood vessels of the prostate are sealed while the enlarged tissue is destroyed. GLL may not be suitable for men with very large prostates.
GLL involves passing a small telescope-like instrument, called a cystoscope, into the urethra (water-pipe) and the green light laser is led in through this telescope. The high-powered green light laser is carefully used to target, heat up and destroy (you may hear this called vaporise) the extra tissue squeezing the urethra. The operation normally lasts between 60-90 minutes and will usually be carried out under a general anaesthetic or a spinal anaesthetic. After the operation, there might be a catheter (Please see our booklet Caring-for-your-indwelling-catheter-at-home) put into the bladder (a catheter is a thin flexible tube that is inserted into the bladder and drains urine into a bag) for a short time, usually less than 24 hours to allow the prostate some healing time. Discharge from hospital is normally within 24 hours of the laser treatment and some men go home on the same day as their surgery. Most men find that they require about a week off work but this may increase if they have a very strenuous job.
For Further information about this procedure see Spotlight on treatment for an enlarged prostate
After the operation there may be a very small amount of blood in the urine.
After GLL, some men will experience a mild burning feeling when first starting to pass urine. Some men find they need to pass urine more frequently for a week or so after the operation with an urgency to pass urine for the first few days.
Some men find that there is a small change in the quality of their erections.
Between 50- 70% of men who have GLL will experience retrograde ejaculation or dry orgasm. This means that at the point of orgasm you will not ejaculate because the semen has passed backwards into your bladder rather than down the penis. This won’t do any harm and will pass out in your urine the next time you go to the toilet but it will make your urine look cloudy. It is however quite common to leak a little urine at the time of ejaculation as the muscles relax. The procedure reduces fertility but does not make you infertile so you should not rely on this as a method of contraception.
Most side-effects and symptoms settle down over a couple of weeks. Retrograde ejaculation is usually permanent when it occurs.
Studies have shown that about 1 in 10 men will need further treatment as the prostate tissue re-grows. However, this may take several years to happen, possibly in the region of 5-8 years.