Comparisonofstandardtransurethralresection,transurethralvapourresectionandholmiumlaserenucleationoftheprostateformanagingbenignprostatichyperplasiaof>40g.HYPERLINK"http://www.ncbi.nlm.nih.gov/pubmed?term=Gupta%20N%5BAuthor%5D&cauthor=true&cauthor_uid=16336334"GuptaN,HYPERLINK"http://www.ncbi.nlm.nih.gov/pubmed?term=Sivaramakrishna%5BAuthor%5D&cauthor=true&cauthor_uid=16336334"Sivaramakrishna,HYPERLINK"http://www.ncbi.nlm.nih.gov/pubmed?term=Kumar%20R%5BAuthor%5D&cauthor=true&cauthor_uid=16336334"KumarR,HYPERLINK"http://www.ncbi.nlm.nih.gov/pubmed?term=Dogra%20PN%5BAuthor%5D&cauthor=true&cauthor_uid=16336334"DograPN,HYPERLINK"http://www.ncbi.nlm.nih.gov/pubmed?term=Seth%20A%5BAuthor%5D&cauthor=true&cauthor_uid=16336334"SethA.SourceAllIndiaInstituteofMedicalSciences,DepartmentofUrology,NewDelhi,India.narmadagupta@hotmail.comAbstractOBJECTIVES:Tocomparethesafetyandefficacyoftwoalternativesforsurgicallytreatingsymptomaticbenignprostatichyperplasia(BPH),i.e.transurethralvapourresectionoftheprostate(TUVRP)andholmiumlaserenucleationoftheprostate(HOLEP),withtransurethralresectionoftheprostate(TURP),thestandardsurgicaltherapy,astreatinglargeprostatesisassociatedwithgreatermorbidity,andtodatethereisnosimultaneouscomparisonofthesethreemethods.PATIENTSANDMETHODS:Weprospectivelyrandomized150patients(50ineachgroup)withBPHandglandsof>40gtoundergoeitherTURP,TUVRPorHOLEP.Theevaluationbeforetreatmentincludedurineculture,serumprostatespecificantigen(PSA)levelestimation,theInternationalProstateSymptomScore(IPSS),peakurinaryflowrate(Q(max)),andtransabdominalultrasonographytoestimateprostatesizeandpostvoidurineresidue(PVR).Theoperativeduration,bloodloss,resectedtissueweight,changeinlevelsofhaemoglobinandserumsodium,nursingcontacttime,durationofcatheterization,andcomplicationswerenoted.AftersurgerypatientswerereassessedfortheIPSS,Q(max)andPVRat6monthsand1year.RESULTS:Thepatientsinallthreegroupshadcomparablecharacteristicsbeforesurgery.Themeanoperatingdurationandin