Revolutionary Treatment: A minimally invasive surgical technique, GreenLight PV Laser System involves a thin fibre inserted into the urethra through a cystoscope.
The ‘Thank You’ cards in Mr Syed Jaffrey’s office in the Galway Clinic are testament to his patients’ satisfaction with their treatment of Benign Prostatic Hyperblasia (BPH) or enlarged prostate with the GreenLight PV Laser System.
Mr Jaffrey, a Consultant Urologist, is one of the first pioneers of the treatment in Ireland and has treated over 120 men successfully since it commenced at the Galway Clinic last year.
As men age, the prostate, which is a walnut sized gland, increases in size causing the gland to press against the urethra and restrict urine flow. Enlargement usually begins in the early to mid 40s and continues throughout life. Half of all men over the age of 50 will develop BPH.
Symptoms of BPH include a weak urinary stream/flow, frequent urination, intermittent flow during urination, frequent night-time urination, difficulty starting urinary flow and acute urinary retention. If left untreated, BPH may lead to bladder and kidney damage
The GreenLight PV Laser System is proving hugely successful in performing PVP (Photoselective Vaporisation of the Prostate) to combat BPH. A minimally invasive surgical technique, the procedure involves a thin fibre inserted into the urethra through a cystoscope. The fibre delivers a high-powered laser to immediately vaporise and remove the prostatic obstruction completely, leaving an open, bloodless channel. Laserscope developed the laser system and fibre optic delivery device in concert with researchers from the Mayo Clinic.
Effusive in his praise for the management of the Galway Clinic and Laserscope, who were both very supportive of his efforts to commence this treatment in Galway, Mr Jaffrey particularly singles out Practice Manager, Laura Coffey, who was instrumental in the establishment of the technique. Mr Jaffrey says that private patients can get an appointment within two weeks of a referral.
Mr Jaffrey’s patients range remarkably in age, from 48 years to one man who is in his 90s. Several of his patients were men who had a catheter and were not suitable for Trans Urethral Resection of the Prostate (TURP). These patients believed that they would have a catheter for life. GreenLight PVP is suitable for a wide patient selection. In both clinical trials and in practise, the treatment has proven to deliver the objective outcomes of TURP, the Gold Standard in the treatment of BPH without any of the adverse reactions.
Men undergoing PVP will be given a general anesthetic or a spinal anesthetic. The length of the operation varies depending on the size of the prostate, however it usually takes 35 to 60 minutes. After the procedure, a small catheter will be placed in the bladder to drain the urine.
“It’s really the way forward. The new techniques can make things happen, especially for patients who have been denied or rejected other treatment. We’ve had fantastic results, recovery is quick and patient satisfaction is high,” Mr Jaffrey says, predicting that there will be a lot of use of laser in urology.
Mr Jaffrey says that patients have told him that when the catheter is removed they obtain an immediate relief of symptoms and a dramatic improvement in urine flow. Patients are usually discharged from the Galway Clinic, once Mr Jaffrey is satisfied with their recovery and they are comfortable. Before discharge, an appointment is made to visit the consultant urologist in six weeks.
Increased frequency in urination for the first few days is an accepted complication. Some of the potential risks of the treatment include difficulty passing urine, which can occur in up to five per cent of patients and bleeding at the time of surgery or later.
A common side effect is dry orgasm or retrograde ejaculation, when the semen goes back into the bladder, instead of coming out through the penis. It occurs in 25 per cent of men following PVP laser. However, it has no effect on sexual activity.
Mr Jaffrey advises men who experience any abnormal symptoms to contact their doctor immediately. He believes that men should have a check-up annually after the age of 45 years. “Early detection is vital. Prostate cancer is curable, if it is caught in time. There are a lot of options available like radical prostatectomy or radiation. Both are equally effective and will depend on the patient’s age and stage of disease,” he says.
According to Mr Jaffrey, Ireland has one of the highest incidences in Europe for high grade and advanced cancers, due to a delay in detection. He believes that the prevalence of cancers in Ireland is due to a combination of diet, the environment, genes, our way of living and stress. He advocates a healthy approach with a balanced diet with fresh food, preferably prepared at home and daily outdoor exercise.