Rigi10™ Malleable Penile Prosthesis
Also Known As
PVP, GreenLight Laser Prostatectomy, GreenLight PVP, Laser PVP surgery, Green Light Laser Treatment, Photo-Selective Vaporisation of the Prostate, GreenLight XPS Laser Therapy
Definition
Photoselective vaporization of the prostate (PVP) is a minimally invasive laser procedure that uses a high-power green light laser to selectively remove excess prostate tissue causing urinary obstruction.1 The procedure employs a 532-nm wavelength laser that is specifically absorbed by hemoglobin in the prostate tissue, resulting in rapid vaporization and precise removal of the enlarged tissue.2 During PVP, a thin fiber is inserted through the urethra via a cystoscope, allowing the surgeon to deliver laser energy that quickly vaporizes the obstructive prostatic tissue while creating a virtually bloodless surgical field.3 This technique effectively creates a wide-open channel through the prostate, immediately restoring natural urine flow and relieving lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH).4
Clinical Context
Photoselective vaporization of the prostate is primarily used for the treatment of benign prostatic hyperplasia (BPH) in men experiencing moderate to severe lower urinary tract symptoms (LUTS).1 This procedure is particularly beneficial for patients who have not responded adequately to medical therapy or those who wish to avoid long-term medication use.2
Patient selection criteria include those with prostate volumes typically between 30-80 ml, though larger prostates can also be treated effectively.3 PVP offers significant advantages for patients on anticoagulation therapy or with bleeding disorders, as the procedure’s hemostatic properties result in minimal blood loss compared to traditional surgical approaches.4
The surgical procedure is typically performed under general or spinal anesthesia as an outpatient procedure. The surgeon inserts a cystoscope through the urethra to the prostate, then delivers the laser energy via a specialized fiber to vaporize the obstructive tissue.1 Most patients experience immediate improvement in urinary flow rates, with studies showing significant increases in maximum flow rate (Qmax) from baseline averages of 7.8 ml/sec to 22.6 ml/sec at 12 months post-procedure.2
Recovery is generally rapid, with most patients requiring catheterization for less than 24 hours—many are catheter-free immediately after the procedure.3 Patients typically return to normal activities within 2-3 days, experiencing minimal post-operative pain.3 Long-term outcomes show sustained improvement in urinary symptoms, with studies reporting reductions in American Urological Association Symptom Index (AUA-SI) scores from 23.9 to 4.3 at 12 months post-procedure.2