What is Transurethral Vaporization of Prostate

Transurethral vaporization of Prostate is a surgery to treat an enlarged prostate gland (benign prostatic hyperplasia). It involves using an electric current to get rid of extra prostate tissue by turning the tissue into a vapor (vaporization).

During this procedure, a tube-shaped instrument (resectoscope) is inserted into the urethra to reach the prostate. The urethra is the part of the body that drains urine from the bladder. It opens at the tip of the penis. A small device on the end of the resectoscope (electrode) creates the electric current that destroys prostate tissue.

This procedure is less invasive than traditional methods of prostate surgery, which involve cutting out the prostate tissue. There is generally less blood loss with this procedure because the tissue is turned into a vapor (vaporized) rather than cut out.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be given antibiotic medicines to prevent infection. If so, take the antibiotic as told by your health care provider.

General instructions

• You may have blood samples taken.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your penis will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• A resectoscope will be inserted into your urethra and moved to your prostate.
• An electrode on the end of the resectoscope will be turned on and moved back and forth across the excess prostate tissue until the tissue is vaporized.
• The heat from the electric current will be used to seal off blood vessels, which will lessen bleeding.
• The resectoscope will be removed.
• A small, thin tube (catheter) will be placed in your urethra to help drain your urine.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Your catheter may be removed or it may be kept in temporarily, depending on factors such as:
  • The amount of prostate tissue that was vaporized.
  • The strength of your bladder.
  • The amount of bleeding that is expected.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Transurethral vaporization is a procedure that uses an electric current to turn extra prostate tissue into vapor. This procedure is less invasive than traditional methods of prostate surgery.
• During this procedure, a tube-shaped instrument (resectoscope) is inserted into the urethra to reach the prostate. No incisions are made during the procedure.
• A catheter will be inserted during the procedure to help you urinate. This may be removed before you leave the hospital, or it may be kept in temporarily.

Care After Transurethral Vaporization of Prostate

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain or discomfort around your penis.
• Blood in your urine.
• Burning during urination.
• Sudden urges to urinate.
• Little or no semen produced during ejaculation (retrograde ejaculation).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not resume sexual activity until your health care provider approves. Ask your health care provider:
  • What activities are safe for you.
  • When you may return to your normal activities.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

General instructions

• Drink enough fluid to keep your urine clear or pale yellow.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• If you go home with a tube draining your urine (urinary catheter), care for your catheter as told by your health care provider. This may include:
  • Washing your hands before and after you touch the catheter.
  • Keeping the area around the catheter clean and dry.
  • Emptying the catheter bag when it is full and monitoring the amount and color of your urine.
  • Avoiding bending or breaking the catheter.
  • Keeping air out of the catheter.
  • Not putting the catheter underwater.
  • Visiting your health care provider to have the catheter removed.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have:
  • A fever or chills.
  • Trouble urinating or controlling when you urinate.
  • More blood in your urine instead of less.
  • Problems getting an erection.
• You start to pass blood clots in your urine.
• You have nausea or you vomit.
• There is more redness, swelling, or pain in your penis.

Get help right away if:

• You have bright red urine.
• You cannot urinate.
• You have severe pain that does not get better with medicine.
• You have shortness of breath.

Summary

• After this procedure, it is common to have some blood in your urine. If you see bright red blood in your urine, however, you should get medical help right away.
• This procedure may cause you to produce little or no semen when ejaculating (retrograde ejaculation).
• Follow restrictions about lifting and sexual activity as told by your health care provider. Ask what activities are safe for you.
• Drink enough fluid to keep your urine clear or pale yellow.