摘要： Various, more minimally invasive laser-based procedures have been introduced into clinical practice for the treatment of symptomatic benign prostatic obstruction (BPO) during the past 20 years as alternatives to open prostatectomy and transurethral resection of the prostate to decrease perioperative morbidity and to achieve comparable outcomes. The most prominent role played the frequency-doubled neodymium:yttrium–aluminium–garnet (YAG) laser or GreenLight laser and the holmium:YAG laser. Since the introduction of holmium laser enucleation of the prostate (HoLEP) in 1998, this procedure has gained worldwide acceptance because of complete dissection of the prostate adenoma from the prostatic pseudocapsule. HoLEP has been proven to be a size-independent, well tolerated and efficient procedure with excellent long-term outcomes. The shallow learning curve of the HoLEP technique has, however, limited its widespread use. A learning curve of at least 25–50 cases was found acceptable using a structured mentorship programme. On the basis of HoLEP, a wide array of so-called ‘me too’ laser-based transurethral enucleation techniques have been described during the past 12 years using diode, GreenLight and thulium lasers, of whom the latter played the most prominent role. Thulium:YAG vapoenucleation of the prostate (ThuVEP) has been found to be a size-independent, well tolerated and effective procedure with low-perioperative morbidity and excellent long-term results. The durability of ThuVEP was demonstrated by a prostate-specific antigen (PSA)-reduction rate of 77.1% at 5-year follow-up. The completeness of adenoma removal by ThuVEP was currently confirmed by a retrospective matched-paired comparison between ThuVEP and thulium vaporesection of the prostate (ThuVARP): the PSA-reduction was significantly higher after ThuVEP compared with ThuVARP (78.9 vs. 23.4%) at 24-month follow-up, which may lead to a higher reoperation rate after ThuVARP during long-term follow-up.