TUVP is an alternative to drug therapy or more invasive surgery for BPH treatment. This treatment might be right for you if any of the following apply:
- You do not want to take another daily pill
- You have tried BPH medication but are unhappy with the side effects
- You do not want to undergo major surgery with a higher risk of side effects and complications
- You want to regain your quality of life with minimal downtime
You made need the following tests prior to TUVP:
- Prostate Ultrasound
- Urodynamics (Less common)
During this procedure, the surgeon uses a scope that has electrode passed through it. The scope goes through the penis into the prostate portion of the urethra. The electrode moves across the prostate surface and vaporizes tissue with an electrical current. Blood vessels are coagulated and sealed. The end result is a visibly opened channel. Click here to see animated video.
After the procedure
Plan on needing a urethral catheter for one night. You will typically have burning with urination after the catheter is removed. This lasts typically for 2-3 weeks. Irritative symptoms such as frequency and urgency can take up to 3 months to improve. You should notice an improvement in stream within a week. You will likely have retrograde ejaculation.
- Typically shorter catheterization times compared to TURP
- The risk of bleeding is very low. May be preferred in very active patients anxious to get back to exercise
- Improvement in symptoms is rapid
- Outpatient procedure
- Durable results
Meta-analysis of 20 randomized trials comparing plasma vaporization (“button procedure”) with TURP:
- Similar improvements in maximum urinary flow rates and symptom scores
- TUVP had lower transfusion requirements (0 versus 4 percent) and shorter length of stay (1.7 versus 3.4 days) but were at higher risk for urinary retention (8 versus 3 percent) and reoperation (5 versus 2 percent)
Transurethral electrovaporization vs transurethral resection for symptomatic prostatic obstruction: a meta-analysis. AUPoulakis V, Dahm P, Witzsch U, Sutton AJ, Becht E SOBJU Int. 2004;94(1):89
The most common procedure related complications are bleeding and urinary tract infections. Short term irritative voiding symptoms are quite common with frequency, urgency and some dysuria (burning). These typically begin after surgery and resolve over a week or two. Long term urinary issues may include urethral stricture resulting in obstruction and prostatic regrowth. Urinary incontinence is very uncommon.
Retrograde ejaculation is common. Men are still able to experience a sensation of orgasm following the surgery. However, because the bladder neck is opened, the ejaculate fluid (semen) will usually travel back into the bladder rather than out the end of the urethra. It is still possible to have children following this procedure, even if there is retrograde ejaculation; however, this will require specialized fertility procedures. There is a small incidence (<5%) of decreased erectile function.
TUVP is contraindicated for patients who:
- Cannot undergo anesthesia
- Have uncontrolled bleeding disorders
- Have acute urinary tract infection (UTI) or severe urethral stricture