Transurethral electrical resection of the prostate (TURP) is still the most commonly performed surgical procedure for benign prostatic hyperplasia (BPH) today, some 100 years after it was introduced by Maximilian Stern in 1926. In the meantime, other minimally invasive treatment methods have also been established and have become an integral part of the treatment of BPH, in particular anatomical endoscopic enucleation of the prostate (AEEP), especially using lasers (e.g. HOLEP = Holmium laser enucleation of the prostate, ThuLEP = bipolar Tullium laser enucleation of the prostate) or with bipolar technique (BiPolEP = bipolar enucleation of the prostate). We are treating an increasing number of older patients with more and more comorbidities. Particularly noteworthy here is the treatment with anticoagulant drugs, which significantly increase the risk of complications from surgical treatments. Due to the different surgical techniques and the topographical and functional anatomy of the prostate and the entire lower urinary tract, all the different surgical methods can lead to a very similar range of complications. In view of this, it is particularly important for the surgeon to be fully aware of the intraoperative, early postoperative and late postoperative complications of the transurethral surgical treatment options for BPH, as well as their origin and therapy, in order to be able to provide individual and optimal patient care. All these complications, their origin and therapy are explained in detail in this chapter, in particular also taking into account TUR syndrome and irrigation fluid absorption (IFA). Overall, this chapter provides a thorough examination of TURP-related complications, as well as insights into alternative procedures and their potential risks, offering practical guidance for preventing and managing these issues in clinical practice and for individual patient counceling.