Complications during transurethral vaporization of the prostate

To review adverse events during transurethral vaporization of the prostate (TVP) and to compare them with those occurring during transurethral resection of the prostate (TURP). One experienced surgeon performed 26 consecutive TVPs and 100 TURPs. We monitored blood loss by photometry, fluid absorption by the ethanol method, and hemodynamic stability with a blood pressure manometer. Total blood loss and the rate of blood loss were significantly lower during TVP. Fluid absorption occurred during most TVPs, but it was mostly small volumes. No sudden drop in arterial pressure was recorded during TVP, but this did occur in 11% of the TURPs. Complications that would normally require medical attention (blood loss greater than 800 mL, fluid absorption greater than 500 mL, or hemodynamic instability) were more infrequent during TVP than during TURP (P = 0.012). Transurethral vaporization of the prostate was associated with fewer intraoperative complications than was TURP.