What to expect

Before the operation

• Consultation. History, examination, flow studies and a frank discussion about whether GreenLight, HoLEP or another option is best.
• Imaging. Prostate size is usually confirmed with ultrasound or MRI if not already measured.
• Blood thinner plan. If you take warfarin, a DOAC, clopidogrel or aspirin, the plan is agreed with your prescribing specialist before the operation (see blood thinners).
• Pre-admission clinic. Bloods, ECG and an anaesthetic review, usually a week or two before surgery.
• Fasting. You will be asked not to eat for six hours and not to drink water for two hours before surgery.
• Antibiotic cover. A single intravenous antibiotic dose is given at induction.

Day of surgery

• Arrive at the hospital admissions desk at the time given on your admission letter.
• Change into a gown. The anaesthetist and Dr Kooner will confirm the plan and answer last-minute questions.
• The operation itself is usually 45 to 90 minutes depending on prostate size.
• You wake in recovery with a catheter in place. Continuous bladder irrigation is sometimes used for a few hours.
• Most men eat a light meal the same evening and get up to walk.

Catheter period (typically 24 to 48 hours)

• The catheter drains urine while the vaporised surface starts to heal.
• Some blood-tinged urine is normal and usually clears over the day.
• Mild bladder cramps when the catheter is in can be helped with simple analgesia.
• The catheter is removed before discharge, usually the morning after surgery. If you live far from the hospital the team may plan a slightly longer stay for the catheter removal to happen in house.

The first fortnight at home

• Urine. Expect short bursts of pink or blood-tinged urine for up to two weeks, especially after activity or a bowel motion. Drinking extra water helps keep it clear.
• Burning. A mild burning or stinging when passing urine is common for a few days and settles on its own.
• Urgency and frequency. The bladder can feel irritable until the raw surface heals. This is normal and improves over the first weeks.
• Pain. Simple oral analgesia (for example paracetamol) is usually enough.
• Bowels. A stool softener is sometimes advised for the first week to avoid straining.

Work, driving and activity

• Driving. Usually restart short-distance driving after a week, once off any opioid pain medication and comfortable with an emergency stop.
• Desk or office work. Most men return in 1 to 2 weeks.
• Manual or labour-intensive work. Typically 4 weeks off to avoid straining while healing.
• Heavy lifting, cycling, horse riding. Deferred for about 4 weeks.
• Flights. Short-haul domestic flights after 1 week if recovery is straightforward. Long-haul discussed case by case.

Sexual activity

• Avoid intercourse or ejaculation for approximately 2 weeks, then resume at your own pace.
• Retrograde ejaculation (where semen goes into the bladder instead of out) is common after any transurethral BPH operation, including GreenLight. Erectile function is usually preserved.
• If sexual function is a central priority, this is discussed in advance so the right procedure choice is made.

Six-week review

• Repeat urine flow rate and bladder scan.
• Symptom score (IPSS) repeated to measure improvement.
• Discussion of medication changes: most men can stop their BPH tablets at this point.

When to call the rooms

• Heavy, continuous bright-red bleeding or clots blocking urine flow.
• Inability to pass urine after the catheter is out.
• Fever above 38 degrees C or shakes.
• Severe pain not settled by simple analgesia.