Bipolar vaporization, also known by other names such as Plasma Vaporization, Button TURP / TURiS vaporization, is an advanced, minimally invasive technique for the treatment of Benign Prostatic Hyperplasia (BPH).
In vaporization, the hypertrophic prostate tissue is dissolved and converted into vapor through thermal plasma energy.
The technique has many advantages. Its disadvantage is that, because the tissue is vaporized, no tissue fragments remain for histological examination (biopsy). For this reason, Dr. Angelos Economides asks the patient beforehand to undergo a preventive PSA check.
How the procedure is performed
The procedure is performed through the urethra, without any external incision, with the patient under general or spinal anaesthesia.
The urologist inserts a special endoscope (resectoscope) through the urethra until reaching the prostate area, with continuous high-definition imaging on a screen. At the tip of the resectoscope there is a special attachment (Plasma Button), shaped like a small button. When low-voltage bipolar current is activated in the presence of normal saline, a thin layer of active plasma forms around this “button”.
The urologist brings the “button” close to the prostate tissue (hovering), and the plasma field instantly disintegrates and vaporises the prostate cells, converting them into vaporised particles, which are removed by the continuous flow of saline. At the same time, the plasma “seals” (cauterises) the blood vessels in the area, ensuring almost complete haemostasis and a clear visual field for the doctor. The technique is indicated for patients on anticoagulant medication (after temporary discontinuation).
At the end of the procedure, the area is left smooth and open, and a temporary Foley urinary catheter is placed.
Advantages
- Because normal saline is used instead of distilled water, the risk of the dangerous TUR syndrome (hypertension/hyponatraemia) is eliminated.
- Postoperative catheter time is usually very short (often removed within 48 hours), allowing the patient to quickly return to their activities.
- The thermal effect is strictly limited to the surface (a depth of a few millimetres), reducing prolonged postoperative discomfort.
