HOW I DO IT

• Photoselective vaporization of the prostate in office and outpatient settings

  Rosenthal D. Brian , DiTrolio V. Joseph, MD Urological Associates of Montgomery County, East Norriton, Pennsylvania, USA

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  The 980 nm/1470 nm diode laser represents the latest in laser technology for photovaporization of the prostate. Surgeons have already used this device in both inpatient and outpatient (office and ASC) setting to produce transurethral resection of the prostate (TURP) like lesions-albeit with fewer complications than traditional methods. The objective of this article is to report the techniques we used to demonstrate its efficacy and safety of the Evolve Dual (biolitec Inc., East Longmeadow, MA, USA) system in an outpatient surgery type setting.

  Keywords: photovaporization, in office, holmium laser prostatectomy, holmium laser enucleation of the prostate (HoLEP), intravesical tissue morcellation,

  Apr 2012 (Vol. 19, Issue 2 , Page 6223)
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• UroLift system for relief of prostate obstruction under local anesthesia

  Barkin Jack , Giddens Jonathan , Incze Peter , Casey Richard , Richardson Stephen , Gange Steven, MD Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada

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  Many men with benign prostatic hyperplasia (BPH) forego therapy because they are dissatisfied with current treatment options. While surgical resection and ablation using many different forms of energy remain the reference standard for BPH treatment, many men seek a less invasive technique that will improve symptoms but not risk the complications associated with tissue removal. The Prostatic Urethral Lift opens the prostatic urethra with UroLift (NeoTract Inc., Pleasanton, CA, USA) permanent implants that are delivered under cystoscopic visualization. The implants literally 'hold open' the lateral prostatic lobes creating a passage through the obstructed prostatic urethra. Voiding and symptoms are significantly improved without the morbidity or possible complications following prostate resection. The entire procedure can be readily performed using local anesthesia. As with all new implant procedures, the technique has evolved with experience. The objective of this article is to describe the most current technique for the delivery of the UroLift implant in order to achieve maximal impact on symptom relief.

  Keywords: prostate, LUTS, photovaporization, outpatient, 980-nm/1470-nm diode laser,

  Apr 2012 (Vol. 19, Issue 2 , Page 6217)
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• Holmium laser enucleation of the prostate technique for benign prostatic hyperplasia

  Kelly C. Douglas , Das Akhil, MD Department of Urology, Thomas Jefferson University Hospital, Philadelphia Pennsylvania, USA

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  Holmium laser resection of the prostate (HoLRP) was first described by Gilling et al in 1995. HoLRP has now evolved into holmium laser enucleation of the prostate (HoLEP) with the advent of the intravesical soft-tissue morcellator. The procedure involves anatomical dissection of the prostatic tissue off the surgical capsule in a retrograde fashion using a high-powered holmium laser followed by intravesical morcellation of the prostatic tissue. Some groups believe that the HoLEP procedure is the endoscopic equivalent to a simple open prostatectomy and may be superior to transurethral resection of the prostate (TURP) or even open prostatectomy. The objective of this article is to explain the techniques for holmium laser enucleation of the prostate (HoLEP).

  Keywords: photovaporization, pelvic organ prolapse, mesh, transvaginal mesh,

  Feb 2012 (Vol. 19, Issue 1 , Page 6131)
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• Olympus PlasmaButton transurethral vaporization technique for benign prostatic hyperplasia

  McClelland Michael, MD Urology Austin, Austin, Texas, USA

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  OBJECTIVE: This article will describe an efficient and effective method of using Olympus PlasmaButton (Olympus, Southborough, MA, USA) for transurethral vaporizations of the prostate (TUVP). METHODS: This method was developed over the last 18 months. Patients undergoing this Olympus PlasmaButton TUVP had the inner aspect of the prostate vaporized until it was believed to be significantly open and unobstructed. RESULTS: Patients were found to do very well with what appears to be durable results. Postoperative short and long term bleeding has not been a significant issue using this method. CONCLUSION: The Olympus PlasmaButton procedure is a new minimally invasive therapy for benign prostatic hyperplasia (BPH). As with all new technologies there are methods that a surgeon learns with increased experience that help make the procedure more effective, efficient, and safer. This article shows one surgeon's technique that has been developed over time and has become a successful way to manage patients undergoing the minimally invasive transurethral vaporization of the prostate. There are probably other vaporization techniques that surgeons have learned with use of the PlasmaButton that may be equally effective.

  Keywords: benign prostatic hyperplasia, photovaporization, transurethral vaporization of the prostate, technique,

  Apr 2011 (Vol. 18, Issue 2 , Page 5630)
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