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Many new developments have recently taken place in the field of BPH minimally invasive surgical treatment. There is a trend towards favoring anatomic endoscopic enucleation of the prostate (AEEP) over older alternatives such as simple open prostatectomy and other options like laparoscopic or robotic simple prostatectomy. The minimally invasive nature of AEEP, its excellent results in the long term, as well as its low morbidity, justify this trend. AEEP was initially described with monopolar energy and then popularized with the use of a Holmium laser. However, there has been a realization that the merits of this endoscopic approach lie in the complete removal of the adenomatous tissue, following the anatomical plane between adenoma and surgical capsule, mimicking the open procedure. The source of energy used to perform AEEP seems to be less relevant. AEEP can be performed using Holmium (2140 nm), Thulium (2000 nm), GreenLight (532 nm) and Eraser (1318 nm) lasers, a well as both bipolar and monopolar generators. End- firing and Side-firing laser fibers can be used, as well as different kind of endoscopic monopolar and bipolar electrodes with different shapes. The learning curve for AEEP is quite lengthy and requires proper training and mentoring.
