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Transurethral Electro-Vaporization of the Prostate (TUEVAP)

Transurethral electro-vaporization of the prostate (TUEVAP) is a newer version of the transurethral electro-resection of the prostate (TURP).

Instead of using an electrical current loop as is done in the TURP procedure, a TUEVAP uses a roller ball to heat the prostate tissue so that it is reduced to vapor. During the process, the small blood vessels in the prostate are sealed off. There is less bleeding during and after this procedure than there is with the TURP. As a result, patients can leave the hospital the same day or next morning.

Recovering after Surgery

If you have surgery, you will need to stay in the hospital one to two days.

Antibiotics to prevent infection may be given prior to or following surgery. Your surgeon will discuss this with you personally and advise you accordingly.

After surgery, you may notice some blood or clots in your urine as the wound starts to heal. If your bladder is being irrigated (flushed with water), you may notice that your urine becomes red once the irrigation is stopped. Some bleeding is normal. It should clear up before you leave the hospital.

What to Be Careful About

Even though you have no visible incision and may have little pain, you are recovering from surgery. Don't try to overdo it getting back into your normal activities. Discuss what to expect during recovering with your doctor. The following guidelines will help you have a smoother recovery:

• Avoid straining, especially when moving your bowel. Eat a balanced, high fiber diet to prevent constipation. If constipation does occur, ask your doctor if you can take a laxative.
• Don't do any heavy lifting.
• Avoid sudden movements.
• Drink plenty of water (up to eight cups a day) to flush the bladder and help prevent infection.
• Don't drive or operate machinery.

Potential Problems to Watch For

• Problems urinating. Although the surgery may make your urine stream stronger almost right away, it may take time before you can urinate completely normally. As you heal, you may have some discomfort or feel a sense of urgency when you urinate. This will slowly disappear. After a couple of months, you should be able to urinate less often and more easily.
• Inability to control urination (incontinence). As you recover, you may have some problems controlling urination. It is rare that this lasts long-term. Usually, the longer you were having problems before surgery, the longer it will take for your bladder and urethra to return to full normal function afterward.
• Bleeding. In the first weeks after TUEVAP surgery, the scab inside the bladder may loosen. Blood may suddenly appear in your urine. Usually, the bleeding stops with some bed rest and drinking fluids. However, if the bleeding is so heavy that it is difficult to see through the urine or if it contains clots or if you feel discomfort, contact your doctor.
• Sexual function. While it may take time for some men to regain full sexual function, most are able to enjoy sex again. Sometimes, concerns about sexual function interfere with sex more than the surgery itself. Talking to your doctor before surgery and understanding what is being done is helpful. Usually, if you could have an erection before surgery, you will after surgery. Prostate surgery usually makes a man unable to father children. This is because the surgery interferes with the function of a muscle. This muscle plays a role in diverting sperm through the penis by blocking the entrance to the bladder. After surgery, sperm goes into the bladder and is then voided out.

Following up after Surgery

Since surgery for benign prostatic hyperplasia leaves behind most of the prostate gland, it is still possible for prostate problems including prostate cancer or benign prostatic hyperplasia to develop or return.

After your surgery, it is important to continue having a rectal exam once a year and to have any symptoms checked by your doctor.

Usually, surgery for benign prostatic hyperplasia offers relief for about 15 years. Only about one man out of every 10 of have the surgery will need a second operation for an enlarged prostate. Typically, these men were younger when they had the first surgery.

Sometimes, scar tissue from surgery requires treatment in the year after surgery. Rarely, the opening of the bladder becomes scarred and shrinks, causing obstruction. More often, scar tissue may form in the urethra and cause narrowing.