TUVP of the prostate is a technical electrosurgical modification of the B-TURP. TUVP can utilize a variety of energy delivery surfaces including a spherical rolling electrode, grooved roller electrode, loop electrode, or hemi-spherical/oval mushroom electrode, amongst other disposables. TUVPs utilize saline and try to improve upon blood loss and patient morbidity. The paucity of new data since the last Guideline looking at TUVP/TURis B-TURPs that vaporize tissue versus tissue removal makes it difficult to add any new commentary about this Guideline recommendation. The only possible new study since the last Guideline, and with a “button” technique and for which no tissue was removed, would be the Yee et al. study. This study is also referenced in the monopolar/bipolar recommendation discussion as well.276 Yee et al. is a 168 patient RCT that showed TUVP/TURis bipolar “button” cases took longer than the M-TURP cases (51.6±24.5 minutes versus 38.5±20.3 minutes; P<0.001). Postoperatively, the TUVP/TURis bipolar group also had a shorter catheter time (33.6±23.7 hours versus 40.8±29.4 hours; P=0.013) and a shorter length of hospital stay (43.14±18.79 hours versus 52.33±30.58 hours; P=0.013) than the M-TURP group. There was no statistically significant difference between the two groups with respect to preoperative and postoperative mean hemoglobin change (0.61±0.72 g/dL in TUVP/TURis versus 0.78±0.99 g/dL in M-TURP; P=0.229). However, the postoperative dysuria score was higher in the TUVP/TURis bipolar vaporization group (5.1±2.3 versus 3.9±2.4; P=0.005).276 As noted in the prior Guideline,14 there were 14 previously referenced RCTs evaluating 1,828 participants comparing bipolar TUVP with TURP.293-312 Mean age among participants was 67 years of age (range: 56-70 years of age). Mean baseline IPSS was 23 points (range: 18-27 points) and mean prostate volume was 51 cc (range: 36-65 cc). The length of follow-up ranged from 3 months to 10.1 years. Overall, outcomes were similar in both groups for long-term response to treatment based on varying definitions using IPSS. These outcomes included mean change in IPSS (through 7 years), need for reoperation, and urinary incontinence. However, TUVP needed fewer blood transfusions compared with TURP (<1% versus 4%, respectively; RR: 0.20; 95% CI: 0.08 to 0.52). Meanwhile, 6 RCTs (n=601) compared the effectiveness of TUVP and B-TURP. The mean age was 66 years of age (range: 60-69 years of age), baseline IPSS was 21 points (range: 18-24 points), and mean prostate volume was 56 cc (range: 32-64 cc). TUVP showed similar needs for reoperation (RR: 1.5; 95% CI: 0.6 to 3.9) and blood transfusion (RR: 0.6; 95% CI: 0.3 to 1.4), and had similar incontinence rates (RR: 0.9; 95% CI: 0.4 to 2.1) as TURP.14