Electrosurgery or laser for benign prostatic enlargement: trumpcard or pitfalls.

Even though transurethral resection of the prostate (TURP) using electric current is still considered the gold standard for the treatment of benign prostatic enlargement (BPE) of patients nonresponding to or unsuitable for pharmacologic treatment, the focus of research is trending towards ‘new’ surgical techniques. These include endoscopic enucleation of the prostate (EEP), prostate vaporization (PV), and vaporesection of the prostate (VRP). As a result, endoscopic laser surgery is getting into the spotlight [1]. In addition to their different physical properties and effect on the prostatic tissue, multiple types of lasers have been tested for the various BPE surgical techniques. Nevertheless, electrosurgery is in frequent use for EEP, VRP, and PV as well. There is an ongoing debate to what extent the energy source attributes to the success of the surgery. Driven by the constant introduction of new laser variants, it will not settle soon. Therefore, current research trends focus on matching surgery type and energy source with the patient's needs, rather than identifying the best surgical technique above all. This narrative review aims to highlight and comment on recent publications (April 2019 to April 2021) in the field of endoscopic BPE surgery, focusing on similarities and differences between laser and electrosurgery.  Open in a separate window Box 1 no caption available