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What is 'green light' laser therapy to treat an enlarged prostate?

In the last several years, many hospitals have switched to "green light" treatment for men with benign prostate enlargement, a nearly universal affliction of older men.

The job of the prostate gland is to squeeze fluid into the urethra (the tube through which urine passes) as sperm pass through during ejaculation. As a man gets older, the prostate gland enlarges and pushes on the urethra, eventually causing the urethra to become narrowed; urination becomes more difficult, as well as more frequent, especially at night.

For years, the best treatment options were medications or various procedures using microwaves, radiofrequency waves or surgical techniques to get rid of excess prostate tissue. The most common surgical procedure, called TURP, typically results in a 2-3 day hospital stay and can lead to considerable bleeding.

Green light laser therapy is different. It uses a very precise laser to vaporize and remove enlarged prostate tissue.

"The beauty of 'green light' treatment. . . . is that there is no bleeding," said Dr. Kevin Loughlin, a senior surgeon at Brigham and Women's Hospital. Moreover, patients go home the same day and results are as good as a TURP, the so-called "gold standard" of care, said his Brigham colleague, senior urologic surgeon Dr. Michael O'Leary.

An additional advantage of "green light" therapy is that "some patients even on blood thinners can have it, patients who would not have been candidates for a TURP,' said Dr. Shahin Tabatabaei, a urologic surgeon at Massachusetts General Hospital. This means that many men who are on anticoagulant medications to prevent strokes can now have treatment for their benign prostate problems without having to go off their medications.

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