Abstract: Objective　To explore clinical effectiveness and safety of five-step method-low power end-fire greenlight laser in transurethral vaporresection-enucleation of prostate (VREP) for the treatment of begnin prostatic hyperplasia (BPH). Methods　Data of 71 patients with BPH who received treatment at Binhu Hospital of Hefei from January 2019 to September 2020 were retrospectively analyzed. Among them, 38 patients were treated with five-step method (the VREP group), and the other 33 patients were treated with photoselective vaporization of prostate (the PVP group). In the VREP group, the operation was performed by a five-step method of locating, grooving, dividing, enucleation and crushing, while in the PVP group, the entire gland was uniformly vaporized layer by layer with 180W power. Perioperative data and complications were recorded and analyzed. Changes in IPSS, QOL, Qmax, PVR, PSA and other indicators before and after surgery were compared between the two groups. Results　All patients were successfully operated without capsular perforation, water poisoning and other complications. The average operation time was ［56.00 (50.75, 59.00) min in the VEP group and 65.00 (57.00, 71.50) min］ in the PVP group (P＜0.01). Values of hemoglobin decreased after operation in the VEP group and the PVP group ［17.00 (12.00, 23.25) g/L and 14.00 (9.50, 20.50) g/L］. The time of indwelling catheterization was ［2.00 (2.00, 2.00) d vs. 2.00 (2.00, 2.00) d］for the two groups, and the hospitalization time was［3.00 (3.00, 4.00) d vs. 3.00 (3.00, 4.00) d］ (P＞0.05). PVR, Qmax, IPSS, QOL and PSA improved significantly 3 months after operation. IPSS［9.00 (7.00,10.00) vs. 10.0 (9.00, 11.50)］and PSA ［3.08 (1.33, 5.98) μg/L vs. 5.05 (3.05, 6.72) μg/L］were significant lower in the VREP group than those of the PVP group (P＜0.05). Conclusion　Five-step method low power end-fire greenlight laser VREP treatment of BPH has the advantages of short operation time, higher effective gland clearance rate and fast postoperative recovery, which can be regarded as a safe and effective surgical method and is worth promoting.

Key words: prostatic hyperplasia, laser therapy, transurethral resection of prostate, treatment outcome, surgical technique, efficacy