Bipolar vaporization of the prostate: is it ready for the primetime?

Although transurethral resection of the prostate is still the 'gold standard' in the surgical management of benign prostatic hyperplasia, it is associated with significant morbidity. This review presents one of its most successful alternatives, bipolar transurethral vaporization of the prostate, a procedure that has emerged during the last decade. The technical principles are presented, together with the trials that compare it with the standard resection technique. The review concludes that bipolar vaporization of the prostate is safe and effective, providing very good hemostasis control and low complication rates, at a significantly reduced cost per procedure. Improved vision and hemostasis make it suitable for patients with cardiac pacemakers, bleeding disorders, or those under anticoagulant therapy. However, long-term follow-up and more randomized trials are still needed, to validate the value of bipolar vaporization.