Category: BPH

VS3-13 - GreenLight XPS 180W prostate vapoenucleation

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective : We present our vapoenucleation technique using GreenLight laser XPS 180W.


Methods : Resectoscope is inserted and bladder inspected. Ureteric orifices are visualized. A working channel is created a 12 o'clock and extended towards 10 and 2 o'clock to the surgical capsule. The apical mucosa around te sphincter is then delimited, and an inverted U incision is created around the veru montanum. With the tips of the scope a gentle pression is then exerted lateral to the veru and the plane between adenoma and capsule developed initailly on the right lobe. This plane and then followed and the apex is detached from the sphincter. A 5 o'clock groove is created from the baldder neck to the veru along hte capsular plane. The right lobe is then vaporized and progressively detached with the aid of the scope, from above and from below to keep it attached to the capsule at 8-9 o'clock. Once the right lobe is completely vaporized the same approache is used to detache the left lobe from the sphincter. Once detaced the left and middle lobe are progressively detache and vaporized en-bloc.


Results : 69 patients were treated. Mean prosate volume 67 cc. A mean of 5.9 KJ/cc of prostated were delivedered. No TUR conversion occourred. Non significant perioperative complication (Clavien > II) occourred. 93% of patients were hospitalized for 2 days. 7% patients were discharged with catheter either for perioperative fever or for retention at TWOC. No patient failed TWOC 1 week after the surgery but one who had the catheter reinserted ofr elevated PVR (> 200 mL) secondary to large bladder diverticulum.


Conclusions : The technique presented is a safe technique and offers several advantages: 1. anatomical disobstruction; 2. high KJ/mL; 3. stepwise and gradual approach to enuclation as in case of problems conversion to standard vaporization is easy and always feasible.

Carlo Luigi Augusto Negro

Consultant Urologic Surgeon
Dept. of Urology - Ospedale Cardinal Massaia - ASL AT
Asti, Piemonte, Italy

Dr Carlo Luigi Augusto Negro, M.D., Urologic & andrologic Consultant Surgeon, dept. of Urology, Ospedale Cardinal Massaia, ASL AT (Asti - Italy).

Giovanna Berta

Consultant Urologic Surgeon
Dept. of Urology - Ospedale Cardinal Massaia - ASL AT
Asti, Piemonte, Italy

Matteo Paradiso

Consultant Urologic Surgeon
Dept. of Urology - Ospedale Cardinal Massaia - ASL AT
Asti, Piemonte, Italy

Giovanni Zarrelli

Head of the Department and Consultant Urologic Surgeon
Dept. of Urology - Ospedale Cardinal Massaia - ASL AT
Asti, Piemonte, Italy