Laser enucleation is increasingly becoming the standard of care for treatment of benign prostatic hyperplasia of all sizes.

Laser technologies for benign prostatic hyperplasia (BPH) have steadily replaced transurethral resection of the prostate (TURP) over the past 10 yr in many parts of the world [1]. For example, the rate of TURP performance declined 47.6% in a US Medicare population between 2000 and 2008 [2]. Techniques for laser prostatectomy used in each country vary, with enucleation preferred in some countries [3] and vaporisation preferred in others [2]. The European Association of Urology and the American Urological Association BPH guidelines panels consider both holmium laser enucleation of the prostate (HoLEP) and photoselective vaporisation of the prostate to be equivalent to TURP, with long-term data favouring HoLEP; however, there are now a plethora of ‘‘me too’’ technologies (both electrosurgical and laser) that need to be considered, with a bewildering array of acronyms, now described [4]. The Thulium:Yttrium-Aluminium-Garnet (YAG) laser (2014 nm wavelength) is one of four contemporary groups of laser systems used for BPH treatment. Holmium:YAG (2140 nm wavelength), 532-nm lasers, and diode systems (a variety of wavelengths) are the others [4]. Thulium laser techniques have followed the development of holmium laser prostatectomy, which evolved from a modality used initially for ablation and resection to enucleation more than 15 years ago [5]. Currently, four distinct procedures utilise the thulium laser: vaporisation (ThuVAP), vaporesection (ThuVARP), vapoenucleation (ThuVEP), and enucleation (ThuLEP). Each is described by different authors [6]. In this edition of the journal, Gross and colleagues, who are pioneers with this wavelength, describe a series of 1080 patients who underwent ThuVEP at their institution [7]. They comprehensively document the periand early postoperative outcomes and complications in this