From the Guidelines

Yes, a 35-watt thulium laser can be used for prostate vaporization.

The European Association of Urology guidelines recommend offering laser resection of the prostate using Tm:YAG laser (ThuVARP) as an alternative to TURP, although with a weak strength rating 1.
ThuVARP has similar operation, catheterisation, and hospitalisation times to TURP, and is equivalent in terms of IPSS but not Qmax, with TURP deemed superior at 12-mo follow-up 1.
The guidelines do not specify the wattage of the thulium laser, but 35-watt is not mentioned as a contraindication or a limitation for prostate vaporization.
Other laser vaporisation techniques, such as GreenLight laser photoselective vaporisation of the prostate (PVP), have been shown to be comparable with TURP in efficacy and safety 1.
However, the evidence for thulium laser vaporisation is limited, and mid- to long-term efficacy and safety results compared with TURP are not well established 1.

The choice of laser vaporisation technique should be based on the individual patient's needs and prostate volume.
Patients should be informed about the risks and benefits of laser vaporisation, including the potential for bleeding and the lack of long-term follow-up data.
The operation time, catheterisation time, and hospitalisation time should be considered when choosing a laser vaporisation technique.
The European Association of Urology guidelines recommend offering laser vaporisation of the prostate using 80-W KTP, 120- or 180-W LBO lasers for the treatment of patients receiving antiplatelet or anticoagulant therapy with a prostate volume of <80 ml 1.

From the Research

The use of thulium lasers for prostate vaporization has been studied in several research papers 2, 3, 4, 5, 6.
A 35-watt thulium laser can be used for prostate vaporization, although the studies mentioned used lasers with higher power outputs, such as 110 W 3, 150 W 2, 6, 180 W 5, 200 W 5, and 300 W 5.
The efficacy and safety of thulium laser vaporization have been demonstrated in various studies, with improvements in symptoms, quality of life, and urinary flow rates 2, 4, 5, 6.
The studies also reported low complication rates and short hospital stays 2, 4, 6.
However, it is essential to note that the specific power output of 35 watts is not mentioned in the provided studies, and the results may not be directly applicable to this specific power setting.

A study compared the efficacy of thulium laser vaporization with other laser types, such as GreenLight XPS laser and diode laser, and found similar outcomes in terms of symptom improvement and complication rates 5.
Another study compared thulium laser vaporesection with transurethral electrovaporization and found that thulium laser vaporesection had slightly better outcomes in terms of catheterization time and postoperative hospital stay 4.

The safety and efficacy of thulium laser vaporization have been demonstrated in mid-term follow-up studies, with low reoperation rates and significant improvements in symptoms and quality of life 6.
The studies reported few perioperative complications, and most were minor 2, 4, 6.