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Paul Hamernik says that “green light” laser surgery has let him enjoy life again. A stock car racer, Paul thought his frequent restroom breaks were an occupational hazard. He assumed his bladder was small and his nerves ran wild—until he learned his PSA level was rising.
“PSA, or prostate-specific antigen, is a normal substance produced by the prostate, usually found in increased amounts in the blood of men who have prostate cancer, infection or inflammation of the prostate, or benign prostatic hyperplasia,” explains Lance Mynderse, M.D., a urologist at Mayo Clinic in Rochester.
“My local doctor suggested I go to Mayo and be evaluated,” says Paul. “He said Mayo had advanced tests and procedures to diagnose and treat prostate conditions that weren’t widely available.”
Fortunately, Paul didn’t have prostate cancer. Because of his age and PSA level, the clinic invited him to join a pharmaceutical trial studying whether dutasteride might prevent prostate cancer in men with elevated PSA.
“I didn’t know anything about the drug, but I wanted to help advance medical science, so I enrolled,” says Paul. “I’ve always been proactive with my health. That’s why I started having my PSA tested early.”
During the four-year, double-blind study, Paul took a capsule—either the drug or a placebo—every day. Half-way through, he had a prostate biopsy and urine-flow analysis.
“I remember having an ultrasound on my bladder after emptying it,” recalls Paul. “The technician thought the machine wasn’t working and went to get help.”
The equipment was fine. Paul’s bladder was holding three times the normal amount of urine; it had become stretched and could no longer empty.
“If I hadn’t been in this trial, the problem might not have been found until my kidneys were affected,” says Paul.
“Paul’s bladder issue was caused by an enlarged prostate, which can obstruct the bladder outlet and restrict urine flow,” says Dr. Mynderse. “His condition was benign prostatic hyperplasia, or BPH—a common part of aging in men.” While all men experience some prostate growth, not all have symptoms—and few as severe as Paul’s.
The trial uncovered a problem routine care might have missed, because Paul had no complaints and a urine-flow test is not usually done. At diagnosis, surgery wasn’t an option: his bladder had lost function. “When the bladder becomes that stretched, it can lose elasticity and contractile strength,” explains Dr. Mynderse.
Reducing prostate size might not help if the bladder cannot squeeze, even after the obstruction is relieved. “We needed to see whether bladder function would recover before planning surgery,” says Dr. Mynderse.
That meant Paul performed self-catheterization five times a day. “I was pretty discouraged,” he says. “It’s hard to find a sterile place, and many facilities aren’t accommodating.” His employer provided a private restroom, and he learned tricks that helped, but they didn’t change the routine.
Mayo Clinic – BPH overview NIH – Prostate health topics
“I became clinically depressed because the catheter stopped me from racing stock cars—something I’ve done almost my whole life,” says Paul. “There’s no catheter support group, and I felt isolated and strange.”
“Going green” with surgery.
Paul’s persistence paid off. “His bladder function returned, and we scheduled photoselective vaporization of the prostate—PVP,” says Dr. Mynderse.
This procedure is often called green-light laser surgery because it emits a highly visible green beam. “The light is generated by lithium triborate, the lasing medium,” explains Dr. Mynderse.
Mayo Clinic urologists pioneered laser treatment for benign prostatic hyperplasia in the 1990s. In fact, Mayo’s Department of Urology is considered the birthplace of the green-light laser for BPH. Today, Mayo is among a small group of U.S. centers recognized as “Centers of Excellence” for PVP laser therapy.
“We vaporize obstructing prostate tissue through a urethral instrument—no incision,” says Dr. Mynderse. “The beam targets the inner prostate, causing minimal bleeding; the by-products are bubbles and fine debris.”
Picture the prostate as an orange: the laser removes the core while leaving the rind. The outpatient procedure is done under anesthesia. “We remove the catheter after 12 hours, and most men urinate immediately,” notes Dr. Mynderse. “This marks a clear shift from the traditional inpatient TURP approach.”
Transurethral resection of the prostate (TURP) has been the standard for decades, yet up to 25 % of patients may face complications such as heavy bleeding, incontinence, or erectile dysfunction. TURP also carries general surgical risks, requires a 1–3-day hospital stay, and needs 4–6 weeks of recovery.
“I went home the same day, pain-free,” says Paul. “Dr. Mynderse is my hero—he removed the catheter and gave me my life back.”
This information is educational and not a substitute for professional medical advice.
