@Article{,
AUTHOR = {Dean S. Elterman},
TITLE = {How I Do It: GreenLight XPS 180W photoselective vaporization of the prostate},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {22},
YEAR = {2015},
NUMBER = {3},
PAGES = {7836--7843},
URL = {http://www.techscience.com/CJU/v22n3/61274},
ISSN = {1488-5581},
ABSTRACT = {The treatments for benign prostate enlargement (BPE), 
also known as lower urinary tract symptoms secondary to 
benign prostatic hypertrophy (BPH-LUTS), have evolved 
significantly over recent years. Where transurethral 
resection of the prostate (TURP) has been the gold 
standard surgery for enlarged prostate glands < 80 
grams, newer modalities such as laser technology have 
proliferated with safe and efficacious results. Notably, 
for prostates larger than 80-100 grams, the surgical 
options were an open, simple prostatectomy or perhaps a 
staged TURP. Both of these surgeries have the potential 
for bleeding complications, electrolyte abnormalities, and 
prolonged hospital admissions. Additional demographic 
and healthcare forces are also at play. Our aging 
population of men is being increasingly successfully 
treated for cardiovascular disease. This means more men 
are on anti-coagulation therapy, many of whom must stay 
on these drugs to prevent stent clotting or stroke. Hospital 
resources, especially overnight hospital admissions do add 
considerable strain to our healthcare systems. Men are 
also increasingly becoming more savvy consumers when 
it comes to their health. Many male patients would prefer 
to take as few medications as possible. Studies of BPH 
medications in Europe and the United States have shown 
drug discontinuation rates between 58%-70% at 1 year. 
Men who are faced with the choice of daily medication 
for life versus an outpatient procedure will often opt for 
the latter, which is in keeping with AUA guidelines that 
still put surgery as a patient choice alongside medications. 
Being able to offer GreenLight photoselective vaporization 
(GL-PVP) with the GreenLight XPS 180Watt system 
addresses all of these concerns. Men with bothersome 
BPH-LUTS with essentially any sized prostate gland, 
can be treated as same-day surgery requiring no overnight 
admission to hospital, while continuing necessary 
anti-coagulants, with significantly diminished risks of 
bleeding, erectile dysfunction, TUR-syndrome. <br/>
Just as there are many ways to perform a TURP, 
techniques for GL-PVP do vary. The objectives of this 
article are to breakdown some of the basic steps for the 
novice user of GL-PVP, as well as impart some “pearls” 
for the more experienced user. Nothing can replace 
hands-on experience for any surgery. The GL-PVP is 
unique in that there are guides such as this and previous 
articles, an excellent simulation device (GreenLight SIM), 
and mentoring programs in place. The success of many 
surgeries has been the standardization of the procedure. 
Performing GL-PVP should not be haphazard. A surgical 
plan based on prostate anatomy and size, cystoscopic 
appearance, and application of routinized techniques 
should yield consistent and optimal surgical outcomes.},
DOI = {}
}