During the 8th Congress of the Southeastern Society of Urology, which was held in Sofia, Dr. Fernando Sancha presented clinical data on the effectiveness of the Green Laser in the removal of large prostate glands. Dr. Sancha, removal of a prostate adenoma is a frequently required surgery for many men. How is medicine developing in this direction? Benign prostatic hyperplasia is a problem that physiologically occurs in a large number of men over 60 years of age. For many years, transurethral resection of the adenoma was traditionally performed, although surgeons recognized the many imperfections of the method. Primarily, transurethral resection can be used for smaller prostate adenomas. After transurethral resection, according to data from the European Urological Association, unwanted complications such as incontinence (involuntary leakage of urine), erectile dysfunction (in seven out of every hundred men), blood loss and corresponding blood transfusion, and often urethral stricture (in approximately 4% of patients). The risk of loss of erection and abrupt termination of sexual life is a very serious reason for men to ask about other methods. For large prostates – years ago the only option was open surgery – extremely traumatic and painful for the patient. Because of the general anesthesia required, it was unsuitable for men with diabetes or heart problems. To the delight of patients and surgeons, medicine has developed very rapidly in recent decades and laser surgery is already being actively used – a proven gentle and effective method. You have vast experience in laser surgery – why Green Laser? We can call the Green Laser the new “gold standard” in the treatment of prostate adenoma. When we talk about the best results for both small and very large prostates, the Green Laser is second to none. The green laser allows maximum absorption of hemoglobin, the so-called “evaporation” of prostate tissue in smaller glands. For larger adenomas, we apply enucleation. With the Green laser, which does not deeply affect the surrounding tissues, there is no risk of severe necrosis. Sexual function is preserved and normal urination is restored. It is also essential for the self-esteem of the patients that after manipulation with a Green laser, the need for long-term catheterization, which is very unpleasant and greatly limits the man in his daily activities, disappears. NEWS_MORE_BOX It is important to mention that recent scientific data reported by the European Urological Association show that diode laser removed prostate adenomas lead to a number of late complications – bladder neck obstruction, bladder stricture and incontinence. The data available to the international medical community are particularly disappointing regarding the use of the diode laser. A need for repeat surgery was observed in more than 32% of patients during 12 months after the initial intervention! It also states,that patients with transient or permanent incontinence, i.e. those who do not retain urine is significantly higher than with alternative treatments. The guidelines of the European Urological Association are not to use a diode laser. There are also data on other lasers that are used in urology in the treatment of benign prostatic hyperplasia. What do you think of them? Yes, there are other types of lasers on the market, with which colleagues remove an enlarged prostate: holmium – very difficult for the surgeon, there are few virtuosos worldwide. My experience shows that colleagues master the Green Laser with a series of 30-40 operations, while other types of technique require much more manipulations to obtain excellent results. Thulium – relatively new to the market, data yet to be published. What sets the Green Laser in the lead is: the safety of the method as non-traumatic and bloodless – for both the patient and the surgeon, and the possibility to remove both smaller and extremely large adenomas of the prostate gland. In practice, it replaces large open operations. At the Hill Clinic, we have been working with the Green laser for 3.5 years and operated on 600 patients. This is an impressive number of manipulations and ranks Hill Clinic among the most active worldwide. The method has been practiced for more than 10 years all over the world, thousands of patients, hundreds of doctors and a huge array of published studies that categorically define it as extremely good. I work with Green Laser all over the world, monthly and with the Hill Clinic team and I am happy to say that Dr. Bocevski, Dr. Kotsev and Dr. Georgiev are world class urologists and experts in Green Laser laser surgery , and patients are operated on and cared for in a way that happens in any good clinic in the world.This is an impressive number of manipulations and ranks Hill Clinic among the most active worldwide. The method has been practiced for more than 10 years all over the world, thousands of patients, hundreds of doctors and a huge array of published studies that categorically define it as extremely good. I work with Green Laser all over the world, monthly and with the Hill Clinic team and I am happy to say that Dr. Bocevski, Dr. Kotsev and Dr. Georgiev are world class urologists and experts in Green Laser laser surgery , and patients are operated on and cared for in a way that happens in any good clinic in the world.This is an impressive number of manipulations and ranks Hill Clinic among the most active worldwide. The method has been practiced for more than 10 years all over the world, thousands of patients, hundreds of doctors and a huge array of published studies that categorically define it as extremely good. I work with Green Laser all over the world, monthly and with the Hill Clinic team and I am happy to say that Dr. Bocevski, Dr. Kotsev and Dr. Georgiev are world class urologists and experts in Green Laser laser surgery , and patients are operated on and cared for in a way that it happens in any good clinic in the world.