Postoperative GLL PVP

• Once the catheter is removed after GLL PVP, most men are able to void. A subset of men may not be
  able to void if the bladder is not ready to go yet and may need the catheter replaced. You should
  drink plenty of fluids during the day to promote increased production of urine. You can restrict the
  amount of fluids you drink later in the day so that you do not have to get up as much at night to
  urinate.
• It will be normal to have burning and stinging with urination for the first two months. There may be
  blood which will develop on an intermittent basis during the first several months as well. Additionally,
  there may be a sense of material or “debris” which is passed during urination.
  You should avoid strenuous activity during the first two weeks, which includes heavy lifting, bike
  riding, treadmill activity, or riding a lawnmower. Avoid sexual activity for two weeks. You may
  resume your normal daily activities. You may resume driving a car.
• During the first several months, the primary milestone to look for is increased urinary flow. As a result
  of the laser procedure, the material which was blocking the urinary pathway has been removed. The
  bladder should now be able to empty with better flow, which you will notice as a more powerful urinary
  stream. It is important to recognize that it may take a much longer timeframe for the frequency of
  urination, particularly frequency of urination at night, to reduce. The bladder has been working
  against obstruction for years. As the bladder has worked against obstruction, it has become thicker
  and less elastic so that its storage capacity is diminished. After the laser procedure, the bladder is no
  longer working as hard against obstruction. Some of the thickening of the bladder muscle will lessen
  and the bladder will regain its elasticity. Its storage capacity will increase. When that occurs, there
  will be less of the “gotta go, gotta get there”, but it may take anywhere from two to 12 months to
  notice that improvement. It is important to recognize that it took years for the bladder to get thicker
  and less elastic, and so it will take a period of time for the bladder to reverse those changes.
• Office follow-up at three to four weeks is advised. Most men are asked to do a “flow study”. You
  should come to the office with a full bladder prepared to urinate. You will be asked to void in a special
  commode which allows measurement of the force of urinary flow to see if the force of urination is
  adequate.