Green Light Laser Surgery (PVP), formally known as Photoselective Vaporization of the Prostate, is a minimally invasive procedure designed to relieve urinary symptoms caused by an enlarged prostate. This condition, Benign Prostatic Hyperplasia (BPH), occurs when the prostate gland obstructs the flow of urine from the bladder. The PVP procedure uses a high-powered laser to vaporize excess prostate tissue, creating a wider channel for urine to pass through. Understanding the potential outcomes and adverse effects is an important part of preparing for this treatment.
Expected Recovery Symptoms and Duration
Almost every patient undergoing Green Light Laser Surgery will experience temporary, common side effects as the surgical site heals. One frequently noted symptom is hematuria, or blood in the urine, which typically appears pink or light red. This discoloration is a normal result of the treated tissue sloughing off and usually subsides within the first few days to one week after the procedure. Increasing fluid intake helps flush the bladder and reduce the presence of blood.
Discomfort during urination (dysuria) is another common symptom in the immediate post-operative phase. This burning or stinging sensation occurs as the urinary tract reacts to the laser energy and the passage of urine over the newly treated tissue. For most men, this irritative symptom is mild and resolves completely within one to two weeks following the surgery.
The bladder may also become temporarily irritated, leading to increased urinary frequency, urgency, and nocturia (the need to wake up at night to pass urine). While obstructive symptoms often improve immediately, these irritative symptoms can persist longer, sometimes taking up to three months to fully resolve as the bladder adjusts. Patients may also notice small tissue fragments or flecks passing in the urine for up to a month, as the body expels the remnants of the vaporized prostate tissue.
Less Common Long-Term Complications
While the recovery period involves transient symptoms, other adverse effects are less frequent and potentially more persistent or permanent. Retrograde ejaculation is the most common long-term sexual side effect, affecting up to 80% of patients. This occurs because the laser vaporization widens the bladder neck, which normally closes during orgasm. Semen travels backward into the bladder rather than forward out of the urethra. The sensation of orgasm remains intact, but the climax is “dry,” and the semen is harmlessly passed later with urine.
A small number of men may experience persistent irritative voiding symptoms lasting beyond the expected three-month recovery window. If urinary frequency and urgency do not improve, it may signal an underlying issue such as incomplete bladder emptying or a developing complication. The healing process can sometimes lead to scar tissue formation, resulting in a narrowing of the urinary channel. This scarring can manifest as a urethral stricture (a narrowing along the urethra) or a bladder neck contracture (a tightening at the junction of the bladder and prostate).
These contractures and strictures occur in a small percentage of patients (urethral stricture rates are cited around 3.4% in some studies) and typically require a subsequent procedure to open the narrowed pathway. Persistent urinary incontinence, or uncontrolled leakage of urine, is a rare but possible complication. It is most often mild and temporary, resolving in a few weeks. Permanent stress or urge incontinence occurs very infrequently, estimated at about one in 200 cases. Erectile dysfunction is also an uncommon long-term complication, with rates reported to be less than one percent, suggesting the procedure rarely impacts the nerves responsible for erections.
When to Seek Immediate Medical Attention
Patients must be aware of “red flag” symptoms that indicate a serious complication or infection requiring urgent medical evaluation. An inability to pass urine (acute urinary retention) requires immediate attention, especially after the temporary catheter has been removed. This can be caused by swelling or blood clots obstructing the newly created channel.
The appearance of a high fever (above 101.5 degrees Fahrenheit), accompanied by shaking chills, nausea, or a general feeling of being unwell, signals a potential urinary tract infection or a more severe systemic infection. Any infection of the urinary tract or prostate needs prompt antibiotic treatment to prevent further progression.
While some blood in the urine is expected, the passage of large, dark blood clots or a continuous stream of bright red blood that does not diminish despite increased fluid intake is a cause for concern. This heavy, persistent bleeding could indicate a significant complication requiring medical intervention. Severe pain in the lower abdomen, pelvis, or rectal area that cannot be controlled with prescribed pain medication warrants an immediate visit to an emergency department.