
A non-inferiority randomized controlled trial (NCT03916536) comparing the outcomes of B‐TUEP and ThuLEP to HoLEP for treating large symptomatic benign prostatic obstruction (BPO). Patients were randomly assigned to HoLEP, ThuLEP, or B‐TUEP in a 1:1:1 ratio, with blinding until the operation. Follow-up at 1, 3, 6, and 12 months revealed no significant differences between groups in Qmax score, IPSS, QoL, or PVR. PSA reduction was similar. Patients with prostate size >120cc showed better IPSS improvement with HoLEP and ThuLEP at one year. Adverse effects were comparable. These findings emphasize the safety and effectiveness of ThuLEP and B‐TUEP for large BPO, suggesting that endoscopic prostate enucleation is technique-based rather than energy-dependent.
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