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Urology · UK

PVP GreenLight laser surgery - day-case BPH surgery, bloodless.

The 180 W GreenLight XPS laser opens an obstructed prostate almost bloodlessly - ideal for 30 to 100 mL glands, men on anticoagulants and anyone keen on a same-day discharge. A consultant urologist who does PVP weekly.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private GreenLight PVP costs in the UK.

Indicative ranges across our partner urology units.

In short

GreenLight PVP for a 40–60 mL prostate: £7,500–£11,000, home same day.

Procedure Indicative range
PVP GreenLight laser (30–60 mL prostate) £7,500–£11,000
PVP GreenLight laser (60–100 mL prostate) £9,500–£14,000
PVP for men on anticoagulants (no drug hold) £8,500–£12,500
Redo PVP (recurrent BPH tissue) £9,000–£13,000
Flexible cystoscopy under LA (pre-op) £450–£750
Urodynamics (invasive flow study) £650–£1,100
Urology consultation only £250–£450

Prices vary by hospital, by the urologist, by gland volume and by whether anticoagulation continues.

The problem

The right laser for the right prostate - and no drug hold if we can help it.

BPH surgery is where insurance-driven lists quietly under-deliver - TURP defaults, unnecessary anticoagulant holds, and no honest comparison with HoLEP, UroLift or iTind.

  • Volume, then modality

    PVP wins 30–100 mL glands. HoLEP wins above 100 mL. iTind and UroLift win the small prostate that must keep ejaculatory function.

  • Keep the anticoagulant if you can

    PVP is uniquely tolerant of aspirin, clopidogrel, warfarin and DOACs. Ask why a hold is being suggested.

  • Talk about ejaculation up front

    60 to 80 percent of PVP patients get retrograde ejaculation. That is a real conversation, not a small-print footnote.

When it helps

When PVP GreenLight is the right step.

The situations we see most, plus the one red flag that means the two-week urology pathway rather than a routine BPH clinic.

  • Moderate-to-severe LUTS from BPH

    IPSS over 8 with quality-of-life impact, poor flow and post-void residuals, despite optimal alpha-blocker and 5-ARI therapy.

  • Prostate volume 30–100 mL

    The sweet spot for GreenLight. Beyond 100 mL, HoLEP or open enucleation often gives more durable relief.

  • Men on warfarin, DOACs or antiplatelets

    PVP is the vaporisation laser most tolerant of continued anticoagulation - often the only reasonable surgical option without a drug hold.

  • Recurrent urinary retention

    Two or more episodes of retention needing catheterisation - a strong indication for definitive surgery.

  • Recurrent UTIs or bladder stones from BPH

    Persistent post-void residual driving infections or stones is a hard indication for outflow surgery.

  • Renal impairment from obstruction

    Rising creatinine or hydronephrosis from chronic outflow obstruction - needs prompt intervention, PVP is often ideal.

  • Preference for day-case over TURP

    Reasonable in the right anatomy - PVP offers a bloodless option with a same-day discharge for many.

  • Red flag: painless haematuria or new bone pain

    Visible blood in the urine or new bone pain in a man over 50 needs same-day urology, not a routine BPH clinic - 2-week-wait pathway.

Procedure options

GreenLight, HoLEP, TURP, UroLift, iTind - and how they compare.

What each option involves and where it sits best in a modern UK BPH pathway.

  • GreenLight XPS 180 W

    The current standard system. 532 nm KTP laser selectively absorbed by haemoglobin, vaporises prostate tissue with excellent haemostasis. Fibre lifetime around 6 to 8 grams of tissue.

  • MoXy liquid-cooled fibre

    The XPS system uses a side-firing liquid-cooled fibre - more efficient tissue removal and less fibre wear than earlier generations.

  • PVP vs HoLEP

    HoLEP enucleates whole lobes and is more durable for glands over 80 mL. PVP vaporises and gives a faster day-case recovery for 30 to 100 mL glands.

  • PVP vs TURP

    PVP has less bleeding, shorter catheter time and can be done on anticoagulants. TURP still gives the largest histology sample if occult cancer is a concern.

  • PVP vs UroLift

    UroLift preserves ejaculation and needs no catheter, but is limited to smaller glands and has higher re-treatment rates. PVP treats larger glands with more durable relief.

  • PVP vs iTind

    iTind is a temporary device with no tissue removal - suitable for men prioritising ejaculatory function in smaller glands. PVP is definitive vaporisation.

  • PVP in the retention patient

    Highly effective in men catheterised for retention. Trial of void success rates around 85 to 90 percent at first attempt post-PVP.

  • Second-generation Moses laser (alternative)

    Holmium- and thulium-based systems (Moses, ThuFLEP) share some of the same day-case advantages. Not GreenLight, but part of the same conversation.

Safety and recovery

What to expect afterwards - honestly.

GreenLight PVP is a mature procedure. The things worth planning are the ejaculation conversation, the raw-vaporisation weeks and long-term re-treatment expectations.

  • GA or spinal anaesthetic

    Either option, chosen with the anaesthetist. Spinal is preferred for older men and those on anticoagulants.

  • Bleeding is minimal

    The defining advantage of PVP - significant bleeding requiring transfusion is under 1 percent, versus 3 to 5 percent for TURP.

  • Dysuria and urgency for 2–4 weeks

    Burning and urgency during the raw-vaporisation phase are common and settle as the crater heals.

  • Retrograde ejaculation

    Occurs in 60 to 80 percent of men after PVP. Worth discussing before surgery, particularly for those still fathering children or bothered by the change.

  • Urinary retention after catheter removal

    Under 5 percent - usually resolves with a second short trial of void, occasionally needs a repeat catheter.

  • UTI in the early post-op weeks

    Around 3 to 5 percent. Antibiotics as per culture, plenty of fluids, and a check MSU if symptoms persist.

  • Bladder neck contracture

    Under 2 percent. Treated by a short endoscopic incision if it occurs - usually years down the line.

  • Re-treatment rate at 5 years

    Around 5 to 10 percent for well-selected PVP in 30 to 80 mL glands. Higher in men with very large or recurrent adenomas.

  • Red flags after discharge

    Fever, spreading pain, inability to pass urine, heavy visible bleeding - same-day urology team or A&E, not a routine call.

Reading your operation note

Your PVP note in four parts. Read the last one first.

Whichever gland size, the note the urologist sends you keeps to the same shape.

A UK consultant urologist reviewing a GreenLight PVP operation note

A quiet reminder

Urology notes can read coldly - we translate them for you.

If you would like us to talk you through the operation note and PSA reset, just ask.

  1. 01 Header

    Prostate volume, laser energy used

    Pre-op ultrasound gland volume, energy delivered in kilojoules and estimated tissue vaporised.

  2. 02 Technique

    Access, findings, adjuncts

    Anaesthetic type, cystoscopic findings, any bladder-neck or median-lobe work, and whether biopsies were taken.

  3. 03 Findings

    Bleeding, catheter and trial of void

    Intra-operative bleeding (usually minimal), catheter time and trial-of-void outcome.

  4. 04 Impression

    Aftercare, PSA reset, follow-up

    Read this first: your medication list, PSA at 3 months (new baseline), and when to return for symptom and flow review.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

GreenLight PVP is usually covered for symptomatic BPH that has failed medical therapy.

Frequently asked

Everything we get asked about PVP GreenLight.

Quick answers on how it compares with TURP, HoLEP and iTind, anticoagulants, ejaculation, cost and recovery.

  • What is PVP GreenLight and how does it work?

    Photoselective vaporisation of the prostate (PVP) uses a 532 nm green wavelength laser (KTP) that is selectively absorbed by haemoglobin. A side-firing fibre passed through a cystoscope vaporises obstructing prostate tissue almost bloodlessly, opening the outflow channel. On the current 180 W XPS system with a MoXy liquid-cooled fibre, typical cases are 45 to 90 minutes.

  • How does PVP compare with TURP and HoLEP?

    PVP has less bleeding, shorter catheter time and can be done on anticoagulants - its defining advantages. TURP gives a fuller histology sample and remains the reference for cost. HoLEP enucleates whole prostate lobes and outperforms PVP for very large glands over 80 to 100 mL, at the cost of a steeper learning curve.

  • Can I stay on my blood thinner?

    PVP is the vaporisation laser most tolerant of continued anticoagulation. Many patients on aspirin and clopidogrel can continue without interruption. Warfarin and DOACs are decided case by case - often continued for cardiac stents and mechanical valves. This is a major reason cardiology-heavy patients are routed to PVP rather than TURP.

  • Will I still have normal ejaculation afterwards?

    Retrograde ejaculation occurs in 60 to 80 percent of men after PVP - the ejaculate goes back into the bladder instead of out. Sensation of orgasm is preserved. If ejaculatory preservation is a priority and your gland is small, UroLift or iTind may fit better - we will say so before you commit.

  • How much does private PVP GreenLight cost in the UK?

    Roughly £7,500 to £11,000 for a 30 to 60 mL prostate, £9,500 to £14,000 for 60 to 100 mL, and £8,500 to £12,500 when performed without stopping anticoagulants. Cystoscopy adds around £450 to £750.

  • How long is recovery?

    Home the same day for most cases, one night for larger glands. Catheter is out the next morning. Back to office work in a week, driving at 3 to 5 days, no heavy lifting for 2 weeks and no cycling for 4 weeks. Full flow benefit is seen by 6 to 8 weeks.

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