ABSTRACT
Objective To study the causes, prophylaxis, and treatment of the severe complications due to transurethral electrovaporization of the prostate (TVP). Methods We analyzed the complications found in 1 910 men with moderate and severe symptoms of prostatism treated with TVP from August 1997 to February 2003 and studied the causes, prophylaxis, and treatment of the severe complications due to TVP. Results Severe complications were found in 78 cases (4.1%). Late mass bleeding in 35 cases (0.18%) was resulted from the abscission of coagulated necrotic tissue of the prostate after TVP. Extraperitoneal water extravasation (hydrocele) in 27 cases (0.14%) was caused by the early incision of the peritoneum in TVP and could be prevented by avoiding early incision of the peritoneum and stopping operation in time. Severe urethral stricture in 9 cases (0.05%) was caused by using thick sheath of cystoscope and cutting the neck of urinary bladder improperly. Urinary bladder explosion in 2 cases (0.01%) was caused by accumulation of air during the process of TVP, but could be protected by removing the air and water in urinary bladder at intervals. Incontinence in 2 cases (0.01%) was resulted from the injured urinary sphincter muscle. Acute renal failure in 3 cases (0.015%) was caused by hypotension. Conclusion Severe complications due to TVP can be prevented and treated. The occurrence rate of severe complications can be decreased by the proper preventive measures and skilled techniques of the operators.