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December 2011

New Feature - How I Do It

GreenLight 180W XPS photovaporization of the prostate

Kevin C. Zorn, MD, Daniel Liberman, MD
Department of Urology, University of Montreal Hospital Center (CHUM), Montreal, Quebec, Canada

The Canadian Journal of Urology. 2011;18(5):5918-5926.

Transurethral resection of the prostate (TURP) is the most common surgical intervention for benign prostatic hyperplasia (BPH), largely due to lower urinary tract symptoms refractory to medical therapy. TURP remains the gold standard for men with prostates sized 30g-80g, while open prostatectomy has been the preferred option for men with glands larger than 80g-100 g and those with other lower urinary tract anomalies such as large bladder stones or bladder diverticula. Unfortunately, these procedures have complications including bleeding (often requiring transfusion in 7%-13% of cases), electrolyte abnormalities (2% TURP syndrome), erectile dysfunction (6%-10%), and retrograde ejaculation (50%-75%). The overall incidence of a second intervention (repeat TURP, urethrotomy and bladder neck incision) has been reported in 12% and 15% of men at 5 and 10 years following TURP. Alternative therapies have been developed with the aim of reducing the level of complications while maintaining efficacy. These include microwave therapy, transurethral needle ablation, and a range of laser procedures (Holmium, Diode, Thulium and 532nm-Greenlight).

Donald G. Skinner, MD
Emeritus Professor and Chairman
Keck School of Medicine of USC
Los Angeles, California, USA

My career development was heavily influenced by innovative, outstanding and stimulating mentors, being at the right place at the right time, and being given the opportunity to start an academic program from scratch and develop it into an outstanding Department prior to my retirement in 2009...