Dr. Alessandro
Calarco, MD PhD

Active guidewire technique for the endoscopic treatment of ureteral stones, compared with the standard technique in a single-centre comparative study (Cristo Re Hospital, Rome) of 100 semirigid ureteroscopies: in 50 cases a thin ureteral catheter was used as an "active guide" instead of the traditional guidewire, in 50 the standard technique. In the study, with the active guide operating times (relative to stone volume) were about 39% shorter and peri-operative infections were 3% versus 30% with the standard technique; these are single-centre results and cannot be transferred automatically to an individual patient. Source: Calarco A, Frisenda M, Molinaro E, Lenci N. The active guidewire technique versus standard technique as different way to approach ureteral endoscopic stone treatment. Arch Ital Urol Androl. 2021;93(4):431-435. doi: 10.4081/aiua.2021.4.431. PMID 34933539.

PubMed →

Endoscopic enucleation of the prostatic adenoma with a bipolar resectoscope. The tissue is detached mainly by blunt dissection along the anatomical planes and only minimally with energy (hence "low energy"); it is then removed by morcellation. The aim is to reduce thermal effects on tissue and, where possible, preserve ejaculation; continence and ejaculation outcomes vary from patient to patient. Dr. Calarco has performed it for about ten years; today BIPOLEP is giving more room to HoLEP, performed with the holmium laser.

Full overview on the Prostate enlargement page →

ZANCLE ("Z" Anatomical Needle Cut Leads Ejaculation): unilateral endoscopic "Z"-shaped incision of the bladder neck and prostate for primary bladder neck obstruction, with the aim of preserving ejaculation. Described in three studies: Urologia Journal 2025 (PMID 40243909), Surgeries 2026 (doi:10.3390/surgeries7030084; 186 patients with follow-up of up to 24 months) and Journal of Clinical Medicine 2026 (PMID 42882160).

Technique page and references →

Robot-assisted simple prostatectomy with the Da Vinci Xi system for very large prostates, performed at San Carlo di Nancy Hospital; the San Carlo Flap option preserves a strip of the mucosa lining the urethra, used as a new sphincter (neosphincter) to keep ejaculation directed outwards (antegrade). The study has been accepted for publication; the reference and DOI will be added as soon as the article is online.

Full overview →