Stavros Gravas, Sonja van Rees Vellinga, and Jean de la Rosette

Our last newsletter on the current top recruiters of the Global Ureteroscopy Study received attention from the readers of the Journal of Endourology. The positive feedback we had is evidence of a growing interest in the centers and researchers who participate in the Global Clinical Research Office of the Endourological Society (CROES) Network. This global network of endocenters has been created and can serve as the basis for promotion of international clinical research and running of multicenter large-scale clinical studies. This has been feasible only thanks to the participation in the CROES studies of 350 centers and 720 investigators from all over the world. This is an exceptional number that shows the acceptance of the CROES endeavour by the endourologic community. It is evident that our colleagues, members of the Endo-family, want to know more about who the CROES participants are and where they work.

Into this frame, the CROES Council thinks that there is a need to bring further into light the centers that work hard and contribute to clinical research in the field of endourology and emerging technologies. For this reason, all the sites and the principal investigators of the completed CROES Global Percutaneous Nephrolithotomy study have been acknowledged in a previous CROES Newsletter. ¹ In addition to this, the top three centers from every ongoing study that currently lead the recruitment race were invited to present themselves and share with us their opinion and experience from CROES. This will give to the involved departments the exposure they deserve and to all of us the opportunity to know about the centers that represent the core of the CROES network.

The present Newsletter is dedicated to the Global GreenLight™ laser for benign prostatic hyperplasia (BPH) study that was closed for initiating new sites in April 2011, but participating centers still have the right to recruit patients. The study design and the objectives have been presented. ² Until now, almost 1000 patients from 30 centers have been enrolled. Dr. Carl-Jorgen Arum (St. Olav's University Hospital, Trondheim, Norway), Mr. Gordon Muir (Kings College Hospital, London, United Kingdom), and Prof. Seiji Naito (Kyushu University Hospital, Fukuoka, Japan) will offer us an inside look at the current top recruiting centers.

Dr. Carl-Jorgen Arum

“St. Olav's University Hospital in Trondheim is the tertiary hospital for all six hospitals for central Norway and the primary hospital for Trondheim, the old Viking capital of Norway. St. Olav's has 8000 employees who are divided into 16 separate clinics. The population base is approximately 750,000. The hospital is closely integrated with The Norwegian University of Sciences and Technology medical faculty. This integration provides ample opportunity for both clinical research as well as basic research. The department of urology has eight consultant urologists, two affiliated uro-oncologists, two urology residents, and four general surgery residents. We have wide competence within uro-oncology, endourology inclusive laparoscopy, and robot-assisted surgery. We have used High performance system (HPS) GreenLight laser treatment since 2004 (photo 1). These treatments are performed primarily as day surgery (∼70%) and using local anesthesia with sedation (∼85%). Results from our first 150 treatments have been published (J Urol 2009;181:1794–1799).

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Photo 1.

Dr. Carl-Jorgen Arum and his team in the operating room.

“We have welcomed the opportunity to participate in the CROES study for several reasons. First of all, on an international scale, we are a relatively small center, thereby limiting our potential to accumulate truly significant clinical study results. Participation has also provided an incentive to quantify the results of this treatment as well as the complications. Until we participated in this study, we did not record Clavien scores. More ‘enlightened’ patients, government, as well as private insurance providers are increasingly requiring documentation of our results and complications. Essentially, this is exactly what CROES is providing. Instead of each center having to develop its own data from scratch, CROES is our own society (not the industry) providing panels of internationally renowned experts within the field deciding what data to record. In addition, CROES provides the technical computer servers for data storage, Internet-based recording and retrieval, and, most important of all, the opportunity to directly compare your center with centers throughout the world. This will potentially allow each center to clearly document its results and, if the results are not good enough, certainly provide necessary argumentation for either changing routines and/or increasing resources to improve results.”

Mr. Gordon Muir

“Kings College Hospital is a tertiary center located in South London that serves a population of more than 700,000 persons. The team is formed by seven consultant urologists, and since 2009, we have performed more than 300 photoselective vaporization of the prostate procedures.

“Mr Gordon Muir (photo 2) was one of the earliest international users of the GreenLight laser; he has taught doctors from all continents and is an expert on minimally invasive prostatic surgery, sexual dysfunction, and penile problems. He is a founder member of the International GreenLight Users Group.

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Photo 2.

Mr. Gordon Muir and his team.

“He was one of the first users of the HPS system and has performed more than 60 procedures in the past year. With the GreenLight study, we expect to assess clinical outcomes, especially in patients with important medical comorbidities that would otherwise have no surgical intervention (anticoagulation, high cardiovascular risk). We also look forward to observe the effectiveness of the HPS technology regarding the subjective and objective improvement of the patient's symptoms.”

Prof. Seiji Naito

“Kyushu University Hospital is one of the oldest and most historic institutions in Japan and has made considerable achievements in many urologic fields in collaboration with its affiliated hospital, Harasanshin General Hospital. For this CROES GreenLight laser study, we cooperated to treat patients with BPH with GreenLight laser or transurethral resection (photo 3). GreenLight laser vaporization is a promising alternative to transurethral resection of the prostate because of its low perioperative morbidity and comparable efficacy. We expect that this CROES global study will clarify the situation of GreenLight laser for the treatment of patients with BPH in daily practice.”

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Photo 3.

Kyushu University Hospital (KUH) team: Dr. Hiroyuki Nomura (left, Harasanshin General Hospital [HGH]), Dr. Seiji Naito (center, KUH) and Dr. Hirofumi Koga (right, HGH).