Abstract: Objective To evaluate the effectiveness and safety of holmium laser prostatectomy for the treatment of large volume benign prostatic hyperplasia （BPH）. Methods A retrospective analysis was conducted on the clinical data of 73 patients with large volume BPH admitted from March 2021 to March 2024. According to different treatment methods, they were divided into an electric resection group and a holmium laser group. Among them,36 patients who underwent transurethral bipolar plasma resection of the prostate were assigned to the electric resection group, and 37 patients who underwent transurethral holmium laser prostatectomy were assigned to the holmium laser group. Surgical related indicators, prostate improvement, and postoperative complications were compared between the two groups of patients. Results The surgery related time indicators in the holmium laser group were shorter than those in the electric resection group, and the intraoperative bleeding was less （P<0.05）. After treatment, the maxmium urine flow rate （Q_max） of patients in the holmium laser group was higher than that in the electric resection group, while the postvoid residual （PVR） and international prostate symptom score （IPSS） were lower （P<0.05）. After designed surgery, the incidence of complications in the holmium laser group was 8.11% （3/37）, which was not significantly different from the 13.89% （5/36） in the electric resection group （P>0.05）. Conclusion The use of holmium laser prostatectomy for the treatment of large volume BPH can shorten surgical time, reduce intraoperative bleeding volume, improve prognosis, and reduce the risk of postoperative complications. It is recommended to application.

Key words: Holmium laser prostatectomy, Large volume benign prostatic hyperplasia, Safety