Wednesday, December 06, 2006

Training in Sweden

Yesterday I travelled to Stockholm, Sweden. I then took a taxi to Västeras. I have been invited to train two urologists from the Public Hospital in Västeras in the use of the new 120 watt Greelight HPS. I had dinner with Dr. Botan Hawas, head of the department of urology and an extremely pleasant man, and we had a chance to discuss the characteristics of this technique thoroughly.

This morning we started at 8 am and we have operated three patients. The first patient was a relatively easy case with a small prostate and he has been the first patient to be operated with the HPS in Scandinavia.

Then we did an 80 gram prostate with a very prominent median lobe, very interesting and with a big educational value. Finally we operated a patient with an advanced prostate cancer that was catheterised. We will do two more cases tomorrow before I return to Madrid.

The hospitals in Sweden are very different from Spanish hospitals, they have a very pleasant decoration, with large living rooms where patients and doctors can sit down to have a coffee. This must make patients feel at home during their hospital stay!!


intotechs said...

Dr. Sancha,

Thanks for all the info you provide on your wonderful blog and happy new year.

Can you please comment further on the cancer aspect and PVP? I am interested in the factors that would influence the decisions to go with PVP or something more aggressive such as open surgery or robotic (da vinci) prostatectomy. Thanks.

Dr. Fernando Gómez Sancha said...

Intotechs, thanks for your comment.

PVP is designed to treat the blockage of the prostatic urethra caused by prostate growth. It improves urinary symptoms and flow in patients with benign prostate growth. It can also help patients with prostate cancer and obstructive growth, but as this technique only removes the central part of the prostate, it is not a curative operation in prostate cancer.

It is mainly used in prostate cancer to palliate the urinary symptoms of patients with advanced prostate cancer (removal of the prostate was not possible, or they were radiated) and obstruction of the urinary tract. Some of these patients end up with a catheter, and PVP is an easy and safe way to solve the problem...

I also use PVP as the initial step for HIFU (High Intensity Focused Ultrasound), removing the central part of the prostate first and then treating the peripheral zone of the prostate with high intensity focused ultrasound, and this is a curative technique for prostate cancer in a subset of patients with relatively small prostates (less than 40 grams) and relatively low PSA and low Gleason grade.

I hope this helps...