Today I travelled to La Coruña, in the north of Spain, to participate as a surgeon in a workshop on photoselective vaporization of the prostate (PVP). I have operated a patient with a relatively big prostate, 80-90 grams. It was a challenging case, the prostate tended to bleed just by rubbing the cystoscope against the urethral mucosa. He had been catheterised for quite a long time and this caused hyperemia and inflamation. As the irrigation power of the cystoscope I use is rather limited, a minimal amount of blood in the operative field can obscure the endoscopic vision. I decided to use a Reuter suprapubic trocar to improve drainage, and connected the two channels of the scope to the inflow of saline. This allowed me to complete the operation without much trouble. The patient will have a small 5 mm wound in the skin under his umbilicus, It did not even need stitches. I have had to return to Madrid in the latest flight as tomorrow morning I have to perform a prostate cryoablation for prostate cancer at my hospital, USP San José, in Madrid.
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