Transurethral resection of prostate (TUR-P) has been considered as gold standard for symptomatic benign prostatic hyperplasia (BPH) not respond to medical therapy. However, significant morbidity mainly bleeding and dilutional hyponatremia (TUR syndrome) were still noted in association with TURP. Recently, several alternatives including bipolar electrosurgical technology and laser prostatectomy have been introduced, aiming to reduce the peri-operative complications of monopolar TURP.

　　The bipolar electrosurgical technology, namely, transurethral resection of the prostate in saline (TURis), has shown comparable short-term and median-term results to traditional TURP but less fluid absorption, sodium decreasing and hemoglobin drop.

　　With the modification of bipolar loop electrode to ‘mushroom’ vapo-resection electrode and the use of OlympusR UES-40 Surgmaster generator (Olympus, Tokyo, Japan), a plasma corona was formed on the electrode surface causing fast vaporization of prostate tissue and concomitant hemostasis. The TURis plasma vaporization technique (TURis-V) has the advantage of not causing sloughing of the tissue and is associated with less bleeding, less capsular perforation and smooth prostatic fossa.

　　Randomized study showed significantly shorter operation time, catheterization period, and hospital stay for TURis-V patients as compared to TURis and monopolar TURP. During the 1, 3, 6, 12, and 18 months’ follow-up, the TURis-V group has superior parameters in terms of International Prostate Symptom Score and maximal uroflow rate.

　　Technique of laser prostatectomy includes pure vaporization by potassium titanyl phosphate (KTP) laser, enucleation with holium laser (HoLEP), and vaporesection with thulium laser (ThuVRP). Laser prostatectomy has comparable efficacy to TURP in terms of symptom and flow rate improvements but no TURP syndrome, less blood transfusion, shorter catheterization times and shorter hospital stay. The main drawback of laser treatment is longer operation time, long learning curve and significant initial cost that are inevitable have prevented its widespread use especially in developing countries.