GreenLight Laser Photovaporization of Prostate Postoperative Instructions

Activity

You must avoid any strenuous activity to prevent the potential for bleeding. This includes any heavy lifting, running, riding an exercycle, etc. This also includes activities, such as raking leaves, mowing the lawn, shoveling snow, etc. These types of strenuous activities must be avoided for 2-3 weeks. In addition, you should avoid driving or riding in the car for 3-4 days. You may go up and down stairs, but limit the number of trips per day. If you do see blood, you should increase the amount of fluids that you are drinking and stay off your feet until the blood clear.

Urinary symptoms

It is normal to have burning and stinging with urination for the first several weeks after surgery. It is also common to have more frequent urination and a greater sense of the urge to urinate. There may not be much warning from the time you feel the urge to urinate to the time when the bladder is ready to empty.

Diet

You may take whatever you would like to eat or drink.

Medications

Take whatever medications are prescribed at the time of your discharge from the hospital. If you are taking any medications on a regular basis prior to your admission to the hospital, you should continue to take those as well. For any aches, pains or headaches, you may use Tylenol or Extra Strength Tylenol. Do not use any aspirin or aspirin-like compounds, such as Advil, Nuprin, Motrin, Bufferin, etc.

Avoid constipation

Do not strain to move the bowels. If you become constipated, use Milk of Magnesia to allow an easier bowel movement. You may find it helpful to take a stool softener, such as Metamucil, one tablespoon twice a day. This may make the bowel movement somewhat larger and easier to pass. You need to be seen in the office two weeks after your discharge. You should call the office to make an appointment. You are allowed to drive to this visit.
Call the office or come to the ER for

Fever greater than 101°F or are completely unable to urinate, you should call the office.

After catheter removal

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.

Follow up appointment

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.