GreenLight Surgery in Singapore | Enlarged Prostate Treatment

Living with an enlarged prostate can significantly impact your daily life, from frequent bathroom trips to interrupted sleep. If you’re experiencing bothersome urinary symptoms that haven’t responded well to medication, GreenLight surgery offers an effective solution. This minimally invasive laser procedure has helped thousands of men in Singapore regain control over their urinary function and improve their quality of life. Our MOH-accredited urology clinic in Singapore specialises in this established laser technology, providing comprehensive care tailored to your specific needs.

GreenLight surgery, also known as photoselective vaporisation of the prostate (PVP), is a minimally invasive laser procedure used to treat benign prostatic hyperplasia (BPH) or enlarged prostate. The procedure uses a high-powered green light laser to precisely vaporise excess prostate tissue that blocks urine flow, creating a wider channel for urine to pass through.

The GreenLight laser operates at a specific wavelength (532nm) that is highly absorbed by blood-rich prostate tissue. This unique property allows the laser to efficiently remove obstructing tissue while simultaneously sealing blood vessels, resulting in minimal bleeding. The procedure is performed through the urethra using a small scope, eliminating the need for external incisions.

GreenLight surgery effectively addresses common BPH symptoms including frequent urination, weak urine stream, difficulty starting urination, and the feeling of incomplete bladder emptying. Studies have shown that patients typically experience significant symptom improvement within weeks of the procedure, with results lasting for many years.

Ideal Candidates

• Men with moderate to severe BPH symptoms that interfere with daily activities
• Patients who have not achieved adequate relief from BPH medications
• Those experiencing medication side effects or preferring to avoid long-term drug therapy
• Men with prostate sizes ranging from small to very large (30-150+ grams)
• Patients taking blood-thinning medications who cannot safely stop them
• Individuals seeking a minimally invasive alternative to traditional surgery
• Men who want to preserve sexual function while treating BPH
• Active individuals looking for shorter recovery times

Contraindications

• Presence of prostate cancer (requires different treatment approach)
• Active urinary tract infections (must be treated first)
• Severe bladder dysfunction unrelated to BPH
• Urethral strictures that prevent instrument passage
• Certain bleeding disorders (requires specialist evaluation)
• Neurogenic bladder conditions

A thorough evaluation by our urologist is essential to determine if GreenLight surgery is appropriate for your specific condition. This assessment includes reviewing your medical history, conducting a physical examination, and performing necessary diagnostic tests to ensure the procedure will effectively address your symptoms.

GreenLight XPS System

The GreenLight XPS represents the current generation of this laser technology, delivering 180 watts of power for efficient tissue vaporisation. This system uses MoXy fibre technology, which provides durability and consistent energy delivery throughout the procedure. The XPS system is particularly effective for larger prostates and can handle challenging anatomical configurations.

Vaporisation Technique

The standard vaporisation technique involves systematically removing obstructing prostate tissue layer by layer. The surgeon creates sweeping motions with the laser fibre, vaporising tissue from the bladder neck to the apex of the prostate. This methodical approach ensures complete removal of obstructing tissue while preserving the prostatic capsule and surrounding structures.

Combination Approaches

In some cases, surgeons may combine vaporisation with limited tissue morcellation for very large prostates. This hybrid approach allows for efficient bulk tissue removal while maintaining the advantages of laser haemostasis. The specific technique is tailored to each patient’s anatomy and prostate characteristics.

Technology & Equipment Used

The procedure utilises a cystoscope (viewing instrument), the GreenLight laser console, specialised laser fibres, and continuous irrigation system. Modern imaging displays provide the surgeon with clear visualisation throughout the procedure. The laser’s precise control allows for accurate tissue removal while minimising thermal damage to surrounding structures.

Pre-Treatment Preparation

Before your GreenLight surgery, you’ll undergo several preparatory steps. Blood tests and urine analysis ensure you’re infection-free and assess your overall health status. You may need to temporarily adjust certain medications, particularly blood thinners, though many patients can continue these under medical guidance. Antibiotics are typically started one to two days before surgery to prevent infection.

On the day of surgery, you’ll need to fast from midnight if general anaesthesia is planned, though clear fluids may be allowed until two hours before the procedure. Arrange for someone to drive you home afterward, as you won’t be able to drive immediately following the procedure.

During the Procedure

GreenLight surgery typically takes 60 to 90 minutes, depending on prostate size. After anaesthesia administration (spinal or general), the surgeon inserts the cystoscope through the urethra to visualise the prostate. The GreenLight laser fibre is then introduced through the scope.

The surgeon systematically vaporises the obstructing prostate tissue, creating a wide channel from the bladder to the urethra. Throughout the procedure, continuous irrigation keeps the surgical field clear and removes vaporised tissue debris. The laser’s coagulating properties minimise bleeding, providing visibility. Patients under spinal anaesthesia may hear the equipment but feel no pain.

Immediate Post-Treatment

Following the procedure, you’ll be monitored in the recovery area as anaesthesia wears off. A urinary catheter is placed to drain the bladder and allow initial healing. Unlike traditional prostate surgery, most GreenLight patients have minimal blood in their urine. Pain is typically mild and manageable with oral medications.

Most patients stay overnight for observation, though some may go home the same day. The catheter is usually removed within 24-48 hours, after which you’ll attempt to urinate normally before discharge. Initial urination may cause mild burning or urgency, which is normal and temporary.

First 24-48 Hours

During the initial recovery period, rest is important though complete bed rest isn’t necessary. Drink plenty of water (8-10 glasses daily) to flush the bladder and promote healing. You may notice mild burning during urination, frequency, or urgency – these symptoms typically improve within days. Avoid straining during bowel movements; a stool softener may be recommended.

Blood-tinged urine is normal initially but should progressively clear. If taking blood thinners, your urologist will advise when to restart them safely. Pain medication is rarely needed beyond the first day or two. Contact your doctor if you experience fever, heavy bleeding, or inability to urinate.

First Week

Most men can resume light activities and desk work within 2-3 days. Continue drinking plenty of fluids to maintain clear urine. Avoid heavy lifting (over 10kg), strenuous exercise, and activities that put pressure on the perineum like cycling. Sexual activity should be avoided for at least one week.

You may experience temporary urinary symptoms including frequency, urgency, or mild incontinence. These are part of the normal healing process as your bladder adjusts to improved flow. Kegel exercises can help strengthen pelvic floor muscles. Your follow-up appointment is typically scheduled within 1-2 weeks to assess your progress.

Long-term Recovery

Full recovery typically occurs within 4-6 weeks. Most men can return to all normal activities, including exercise and sexual activity, by week 3-4. Urinary symptoms continue to improve over several months as the prostate heals and bladder function normalises.

Long-term follow-up includes periodic assessments of urinary function and prostate health. While GreenLight surgery provides durable results, the remaining prostate tissue can still grow over time. Regular monitoring ensures any future issues are identified early. Most patients enjoy sustained symptom relief for many years following the procedure.

GreenLight surgery offers numerous evidence-based advantages for treating enlarged prostate. The minimally invasive nature means no external incisions, resulting in less pain and faster recovery compared to traditional surgery. Most patients can return home within 24 hours and resume normal activities within days rather than weeks.

The procedure provides immediate and sustained improvement in urinary symptoms. Studies show significant increases in urine flow rate and reduction in post-void residual urine volume. Patients report better sleep quality due to reduced nighttime bathroom visits and improved overall quality of life.

The laser’s coagulating properties result in minimal blood loss, making it safe for patients on blood-thinning medications. Unlike some BPH treatments, GreenLight surgery has low rates of sexual dysfunction, with most men maintaining their sexual function post-procedure. The treatment eliminates the need for long-term BPH medications and their associated side effects, providing a more permanent solution to bothersome urinary symptoms.

Common Side Effects

Temporary urinary symptoms are the most frequent side effects following GreenLight surgery. These include increased frequency, urgency, and mild burning during urination, typically lasting 2-4 weeks. Some men experience retrograde ejaculation (semen entering the bladder during orgasm), which is harmless but permanent in about 50% of cases.

Mild blood in the urine may occur intermittently for several weeks, especially after physical activity. This usually resolves without intervention. Temporary difficulty with urination immediately after catheter removal affects some patients but typically improves within days with proper hydration and patience.

Rare Complications

Serious complications are uncommon with GreenLight surgery. Urinary tract infections occur in less than 5% of patients and are treated with antibiotics. Urethral stricture (scar tissue narrowing) is rare but may require additional treatment if it develops. Persistent incontinence affects less than 1% of patients.

Incomplete symptom relief may occur if significant prostate tissue remains, potentially requiring retreatment. This is less common with current laser technology and experienced surgeons. Our urologists use established techniques and careful patient selection to minimise all risks while maximising treatment success.

The cost of GreenLight surgery in Singapore varies based on several factors including hospital choice, room type, and the complexity of your specific case. The total fee typically encompasses surgeon charges, anaesthetist fees, hospital facility costs, operating theatre time, and the specialised laser equipment use. Post-operative care and follow-up consultations are usually included in the initial quote.

While the upfront cost may be higher than ongoing medication, GreenLight surgery often proves cost-effective long-term by eliminating the need for daily BPH medications. The procedure’s durability means most patients won’t require retreatment for many years, if ever.

Quality of care should be a primary consideration when evaluating treatment options. Our experienced urologists use established protocols and modern equipment to ensure optimal outcomes. During your consultation, we’ll provide a detailed cost breakdown specific to your treatment plan.