3rd International Course: Urology in the 21st Century, Sevilla

This morning I took the High Speed Train to Sevilla to participate in the III Curso Internacional: Urología del Siglo XXI - Medicina Basada en la Evidencia Científica, organised by the Hospital Universitario de Valme and the Department of Urology of the Cooper Hospital from New Jersey, USA.

My task was to participate in a round table on "New Technologies vs TURP", moderated by Dr. Pilar Laguna and with the participation of Dr. Jiménez Cruz (defending Holmium), Dr. Vicente (defending TURP), other alternatives (Dr. Pilar Laguna) and Simple laparoscopic prostatectomy (Dr. Octavio Castillo, from Chile - in the photo below, Dr. Vicente's face and Dr. Castillo delivering his presentation).

We had 10 minutes for individual talks and then we had a hot and fun discussion on the differences among techniques. I defended that no technique is perfect, but that probably Greenlight HPS laser prostatectomy offers the best balance between positive aspects and negative aspects among any existing technique.

A very well organised course... with massive attendance.

Visitor from Barcelona

Today I celebrated my 40th birthday with a full day surgical list... We received the visit of Dr. Pilar Luque, from the Hospital Clinic from Barcelona, who has recently started to use the Greenlight HPS laser for the treatment of BPH. I had three patients in the list, but she could only see one case of a man with a big prostate. We had time enough to discuss all surgical tricks and tips. It is possible that I will go to give her a hand to Barcelona soon.

Weekend in Amsterdam

I spent this weekend in Amsterdam, in the company of my colleagues and friends, Alex Bachmann, Jean de la Rosette and Oliver Reich. The goal of this meeting was to prepare a symposium on Greenlight Laser Prostatectomy that will be celebrated during the Annual Congress of the European Asociation of Urology. It promises to be a symposium charged with news and innovations... Luckily, apart from work, we had the chance to had dinner in a fabulous Japanese restaurant... this is the only photo from this trip, so I post it here....

Visitors from Vigo

Today we had the pleasure to receive the visit from two prestigious urologists from Vigo, who will start soon with their first cases with the Greenlight HPS high power laser. I operated a patient in their presence, and we had a chance to review in detail all the subtleties of the surgical technique... It seems that they want me to help them in Vigo with their first cases.... we had a great time together and we even had time to enjoy a great lunch...

Surgeries in Pamplona

I flew to Pamplona, where I spent the night because we started to operate early the next morning. I had been invited to perform three operations in the State Hospital Virgen del Camino. Once again we did three cases of endoscopic prostatectomy with the Greenlight HPS laser. It was a nice morning and we all had fun. All patients fared very well, as I was told later that week. I then returned to Madrid.

Conference to worldwide Greenlight distributors...

AMS, American Medical Systems, the manufacturer of the Greenlight HPS laser, invited me to share my experience with this laser with their worldwide distributors. I was already in Barcelona and I prepared a talk discussing my vision on this surgical procedure for the treatment of BPH in front of representatives from many companies from all corners of the world. I explained my experience and my opinions and enjoyed the company of some of the distributors that already had invited me to visit them, from India, Sweden, Saudi Arabia, South Africa.... then I returned to Madrid....

World Congress on Controversies in Urology

On February 1st I participated in the First World Congress in Controversies in Urology (CURy), that was held in Barcelona, Spain. Here I had two commitments. One, to present the poster with the first results of the prospective multicentric study of the IGLU Group (International Greenlight Users), with the results of the Greenlight HPS 120 watt laser in patients in urinary retention, under anticoagulation, and with big prostates, that I copy below.



Another one, to participate in a debate where we addressed what was the best treatment for BPH. TURP (Transurethral resection of the prostate), the treatment with the Greenlight HPS laser or the Holmium laser enucleation of the prostate (HoLEP). In this session I confronted Prof. Marberger (who defended TURP), and Prof. Montorsi, the current editor of European Urology (who defended HoLEP) It was an interesting and intense debate, where I think it was clear that TURP continues to have a considerable morbidity and even mortality, and that the technical difficulty of HoLEP limits seriously its clinical use, the learning curve is too long. The Greenlight laser emerges as a treatment option that is very advantageous for the patients, due to its high efficacy and minimum morbidity... There are 1600 greenlight laser units worldwide and more than 300.000 patients have been treated.

In this photo, speaking, sitting by Dr. Montorsi (Italy) and Dr. Marberger (Austria)...

In this photo, Dr. Lepor (USA) and Dr. Djavan (Austria), who moderated the session.

Surgeries in Gran Canaria

Once again I flew to Gran Canaria to operate with Dr. Juarez. We did two procedures in two BPH patients, with the new Greenlight HPS laser, and everything went smoothly. I love to travel to Gran Canaria. The weather was not too good, but it is always a pleasure.

Visitor from Zaragoza

Today we received the visit of Dr. Luis Rodriguez Vela, an eminent urologist very devoted to andrology, from Zaragoza. He has decided to start offering Greenlight HPS treatment for his patients suffering from Benign Prostatic Hyperplasia. He spent the day with us, I had scheduled four laser surgeries, so we had a great time discussing the subtleties of this surgical technique....

Conference in Asturias

Today I took a plane to Asturias, to participate in the annual meeting from the Urological Society of Asturias. Then I returned to Madrid, unfortunately I could not stay for the dinner.

Surgery in Barcelona

From Santiago,I took a flight directly to Barcelona, and I could see from the plane the pyrenees covered with snow...

There I helped Dr. López Costea, at the Quirón Hospital in Barcelona, to operate a patient with a huge prostate. Then I returned to Madrid, late, as always, feeling better from my flu, but wanting to get some rest...

Surgical day in Santiago de Compostela

Yesterday I arrived at Santiago de Compostela, with a terrible flu. I had been invited to perform a live surgical procedure at the Hospital Universitario de Santiago de Compostela, where Dr. Marqués Queimadelos organises each year the Update in Urological Surgery Meeting, sponsored by the SINUG and the Sociedad Gallega de Urología.

The patient had been submitted to a TURP (Transurethral resection of the prostate) and had a very irregular prostatic urethra. Visibility was not perfect, but he got better and better and at the end the result was excellent.

Then in the afternoon, I did a presentation on Greenlight laser prostatectomy and then we went to have dinner to the famous "Hostal" in front of the Cathedral. It was raining and the view of the cathedral was breathtaking....

Fast trip to Miami

In this ocassion I was invited by AMS (American Medical Systems) to travel to Miami this tuesday, to give a one hour talk on Greenlight HPS for the treatment of BPH and to participate in a round table with eminent American urologists, Ricardo González, Gregg Eure and Joe Nuzzarello.. It was a wonderful meeting, albeit brief, I had to return on Wednesday afternoon. I just had time to take a boat and watch the beautiful Miami Skiline on my arrival...

Visitor from Iran

The 19th I met for the first time Dr. Dariush Marzbani, a prestigious urologist from Teheran, Iran. He came to madrid to visit us for some days decided to know the truth about the treatment of benign prostatic hyperplasia with the Greenlight HPS.

We shared two surgical sessions, the 20th I operated three patients, and the 21st, I also did three cases. The 21st we also received Dr. Gelabert, from Mallorca, to see the operations. Dr. Marzbani left very happy and convinced, because we saw very interesting a varied cases. Small prostates, big ones, and even a patient who already had had a TURP and an open prostatectomy...

The major problem for the introduction of this technique in Irán seems to be the blockade the USA maintains on Iran. Apparently american companies cannot sell in Iran, specially when high technology is involved.

University Hospital Arnau de Villanova, Lleida

The night of the 16th I took the high speed train to Lleida. The following morning we woke up early to visit the University Hospital Arnau de Villanova to participate in a surgical session to demonstrate the new HPS laser in two patients with benign prostatic hyperplasia.

Then I rushed back to Madrid in the High Speed Train (AVE). Christmas is near and I will have a chance to rest for a while.

BAU 2007 - National Urology Congress in Belgium

After my trip to the Canary Islands, I had to wake up very early to catch a flight to Brussels departing at 06:30. I had been invited to participate in the 7th Annual Congress of the Belgian Urological Association. I prepared a lecture on Greenlight Photoselective Vaporization for BPH.

The plane made us wait for three hours. This was compensated by the sight of an interesting fenomenon from the plane. A circular rainbow, that was resting on the clouds. A real beauty.

Then I drove to the congress center, where I did my lecture. Everything went fine. Some belgian urologists told me they would come soon to visit me in Madrid.

There I met my friend Jean de la Rosette, and we had lunch together. It is always a pleasure to learn from him. Then I returned to the airport, to go back to Madrid. I was really tired when I got home, but happy.

Surgeries in Gran Canaria

This thursday I took a plane to Gran Canaria, where we had programmed a joint surgical session with Dr. Juarez del Dago. I love coming to Gran Canaria, we always have a great time. The pity is that I flew in the morning flight and returned at night. We did two operations that were uneventful and satisfactory.


Then Dr. Juarez sent me this recently published news clip.

Conference in Doha, Quatar

This time I travelled to the middle east to participate in the PACS (Pan Arab Continence Society) conference in Doha, Quatar. Quatar is a relatively small country, but extremely wealthy, due to their abundance of the black gold. I arrived late at night after my trip and this is the first thing I saw from Doha as I woke up the next morning.

Then I went to the congress venue, where I dictated my conference. I lectured on greenlight laser prostatectomy for bening prostatic hyperplasia in a session covering all treatment options for this disease. Again, I met Dr. El-Hilali, from Canada there.

Then I had time enought to wonder around a beautiful market in the city, where I bought a shisha pipe, and different flavours of tobacco... there were also lots of spices... really beautiful.

Then I returned to Madrid, that same night. In principle, I prefer the trips where I do surgeries rather than lectures. It is much more interesting and fun. I received an invitation to visit Doha again in the near future to perform a mentoring session.

New Delhi - Army Hospital (R&R)

I finally arrived at New Delhi at night. It was 02.00 am and as always, when I stepped out of the aeroplane I was hit by the special odour of India... a scent that brought back all my previous experiences in this wonderful country. There was a heavy fog, and the representatives of Hospimédica, the distributor of the GreenLight laser in India, came to pick me up and drove me to the hotel. I was half asleep when I reached there. The next morning I had to operate at the Army Hospital (Research and Referral), in the afternoon I had to lecture on BPH treatment with the Greenlight laser.


The hospital had an amazing intelligent operating room. The surgery went fine, it was transmitted to the conference room. The patient had a relatively small prostate and the operation only took 30 minutes. I greeted the patient and then I went down to the conference room where I found some old friends, as Dr. Wadhwa, Dr. Sood and Dr. Gupta.



Later on I dictated my conference and I attendend a banquet celebrating the congress, with an indian orchestra and all. I enjoyed Indian food and the company of the indian urologists and the Hospimedica personnel, and then I rushed to the airport, that was unbelievably filled up to its limit with people. It was an oddyssey to reach the plane.

Surgeries and conference in Nijmegen, The Netherlands

The department of Urology at Nijmegen (St. Radboud) is well known all over the urologic world, due to their excelent basic and clinical research. They invited me to participate in a scientific meeting on advances in urology. I woke up at 04.00 am to fly to Brussels, and from there I drove to Nijmegen. When I arrived at the hospital, there were two patients waiting for me...


One of them had a 70 gram prostate and I used the 80 watt GreenLight PV system. The second patient had a 50 gra prostate that I did with the Greenlight HPS 120 watt system. Both surgeries were uneventful. I could feel a certain skepticism in the air initially, but when they saw how little aggressive this operation is, the bloodless surgical field and the final endoscopic view, I think they were impressed. Holland is the slowlier adopter of this technology in Europe, I believe they will embrace it faster after this...


The we went to the meeting room where I lectured on Photoselective vaporization of the prostate and then we celebrated a round table on minimally invasive treatments. It was a pleasure to share this session with Dr. Frank d'ancona, Dr. Steffens, Dr. Schout, Dr. Karthaus and Dr. Peter Mulders... all of them truly amazing urologists...



We had a great time and then I drove back to Brussels, where I would take a flight to New Delhi the next morning.