Does TURP Use Laser Technology?
No, traditional Transurethral Resection of the Prostate (TURP) does not use laser technology—it uses electrocautery with an electrified wire loop to resect prostatic tissue. 1, 2
Understanding TURP vs. Laser Procedures
Standard TURP Technique
- TURP uses an electrified loop inserted through a resectoscope to systematically resect prostatic tissue in strips using electrocautery energy 2
- The procedure can be performed with monopolar or bipolar electrocautery, but neither variant uses laser technology 3
- TURP remains the gold standard surgical treatment for benign prostatic hyperplasia (BPH) against which other techniques are compared 1, 4, 3
Laser Procedures Are Separate Alternatives
The AUA guidelines clearly distinguish laser therapy as a separate category of treatment options for BPH, not a variant of TURP 1:
Laser-based procedures include:
- Transurethral laser coagulation (visual laser ablation using Nd:YAG laser with right-angle fibers held 2mm from tissue) 1
- Transurethral laser vaporization (laser fiber in direct contact with tissue to create furrows) 1
- Transurethral holmium laser resection/enucleation (HoLEP) (uses holmium laser fiber in a specially adapted resectoscope) 1
Key Distinctions in Nomenclature
Important caveat: The term "transurethral" refers only to the approach (through the urethra), not the energy source used 1. This creates potential confusion, as both TURP and laser procedures are "transurethral," but they use fundamentally different technologies.
Energy Sources Compared:
- TURP = Electrocautery/electrosurgical energy 2, 3
- Laser procedures = Various laser wavelengths (Nd:YAG, holmium, KTP, thulium, diode) 1, 4, 5
Clinical Performance Differences
While holmium laser procedures have demonstrated effectiveness equivalent to TURP, they remain distinct procedures with different complication profiles 1:
- Laser coagulation and vaporization show higher rates of postoperative urinary retention (21% vs. 5% for TURP) and irritative voiding symptoms (66% vs. 15% for TURP) 1
- HoLEP offers reduced bleeding risk and absence of TURP syndrome but requires a significant learning curve and specialized equipment (morcellator) 1, 4, 6
- TURP has an 8% transfusion rate compared to lower rates with laser techniques 2, 6
Bottom Line for Clinical Practice
When discussing surgical options with patients, clearly distinguish between "TURP" (electrocautery-based) and "laser prostatectomy" (various laser techniques) to avoid confusion 1, 4. These are alternative procedures, not variations of the same technique, despite both being performed transurethrally.