title: Common trend: move to enucleation-Is there a case for GreenLight enucleation? Development and description of the technique.
abstract: BACKGROUND
  Transurethral laser prostatectomy has evolved as a viable alternative for the management of benign prostate enlargement. Since the renaissance of laser prostatectomy with the advent of the holmium:yttrium-aluminum-garnet laser in the 1990s, various lasers and subsequent procedures have been introduced. These techniques can be categorized as vaporizing, resecting, and enucleating approaches. Photoselective vaporization of the prostate (PVP) is dominated by high-power lithium triborate (LBO) crystal lasers (GreenLight XPS). The mainstay of this technique is for the treatment of small to medium prostate volumes whereas enucleating techniques, such as holmium laser enucleation of the prostate and thulium enucleation of the prostate, focus on large-volume glands. In order to perspectively "delimit" LBO into the field of large-volume prostates, we developed LBO en bloc enucleation to render it as a competing transurethral enucleating approach.
  
  
  METHODS
  We present a detailed stepwise progressive technique developed in Madrid, Spain, for the complete removal of the transitional zone by vapoenucleation. The steps include exposition of the prostatic capsule by PVP toward the peripheral zone, thereby identifying the anatomical limits of enucleation. Subsequently, the transitional zone is excised in a single bloc and morcellated after its placement into the bladder.
  
  
  CONCLUSIONS
  This new GreenLight en bloc enucleation technique allows to treat larger prostates than those previously treated with the PVP technique.
authors.affiliation: ICUA, Clínica CEMTRO, Ventisquero de la Condesa 42, 28035, Madrid, Spain, fgomsan@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomez Sancha
authors.forename: Vanesa Cuadros
authors.initials: VC
authors.lastname: Rivera
authors.forename: Georgi
authors.initials: G
authors.lastname: Georgiev
authors.forename: Alexander
authors.initials: A
authors.lastname: Botsevski
authors.forename: Julian
authors.initials: J
authors.lastname: Kotsev
authors.forename: Thomas
authors.initials: T
authors.lastname: Herrmann
mesh_terms: D001881:Borates; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D018020:Lithium Compounds; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001881:Borates; D018020:Lithium Compounds; C021051:lithium borate