Objective To compare the safety and efficacy of the two surgical approaches,plasma kinetic resection of the prostate (PKRP) versus holmium laser enucleation of the prostate (HoLEP),in the treatment of benign prostate hyperplasia (BPH).Methods From August 2008 to June 2012,retrospective analysis were made of 812 BPH cases,including 410 treated by PKRP (PKRP group) and 402 by HoLEP (HoLEP group).No significant differences were observed in the pre-operative data [age:(71.9± 8.2) year vs (72.8±8.6) year,P＞0.05; prostate volume:(61.2±23.3)ml vs (58.8±29.5) ml,P＞0.05; IPSS scores (23.8±3.6) vs (23.5±3.7),P＞0.05; QOL scores (4.5±0.7) vs (4.4t0.7),Qmax:(7.1± 3.3) ml/s vs (7.1±3.4) ml.s,P＞0.05 and IIEF-5 scores (18.4±3.5) vs (18.2±3.4),P＞0.05] between two groups.The safety and efficacy of the two approaches were assessed based on the peri-and postoperative outcome data and follow-up data.Results Both groups displayed significant improvements in IPSS (PKRP group:(23.8±3.6) vs (6.3±1.7) ; HoLEP group:(23.5±3.7) vs (6.2±1.9),P＜0.05),QOL (PKRP group:(4.5±0.7) vs (1.8±0.7); HoLEP group:(4.4±0.7) vs (1.0±0.6),P＜0.05) and Qmax (PKRP group:(7.1±3.3) ml/s vs (23.9±4.5) ml/s; HoLEP group:(7.1±3.4) ml/s vs (23.9±4.2) ml/s,P＜0.05) 6 month after surgery.However,we identified there was no significant differences between the two groups in the follow-up data (P＞0.05).There was no significant difference compared with preoperative IIEF-5 and between both groups after surgery.Patients in the HoLEP group displayed lower risk of haemorrhage (Haemoglobin decrease:(1.2±0.6) g/dL vs (1.8±0.7) g/dL (P＜0.01),shorter bladder irrigation (22.8± 11.8) h vs (30.4±14.4) h (P＜0.01) and shorter catheter indwelling (4.1±1.9) d vs (5.4±3.0) d (P＜ 0.01) as well as shorter hospital stays (4.1±1.9) d vs (5.4±3.0) d (P＜0.01).A larger amount of prostate tissue was retrieved in the HoLEP group (55.2±16.5) g vs (43.9±15.8) g (P＜0.05),but the operative time was longer in this group than that in the PKRP group (87.1±41.9) min vs (60.5±19.6) min (P＜ 0.01).No TUR syndrome was detected in both groups.10 patients needed re-catheterization due to urine retention after catheter removal in the PKRP group,while 5 in the HoLEP group required re-catheterization.But the catheters were all removed after 3-5 d.4 patients required blood transfusion in the PKRP group because of blood loss after the operation while none in the HoLEP group.The incontinence presented in both groups (30 in the PKRP and 35 in the HoLEP group),but all patients recovered within 1-6 months.Re-operations due to the urethral stricture and bladder neck contracture were needed in 4 patients of the PKRP group and in 2 of the HoLEP group.In patients who still had sexual active,retrograde ejaculation was reported by 45 patients in the PKRP group and 49 patients in the HoLEP group.There was no significant difference in the rate of postoperative urinary retention,blood transfusion,reoperation,incidence of stress urinary incontinence and retrograde ejaculation(P＞0.05).IIEF-5 was also recorded,which was completed by 99 in PKRP group and 102 in HoLEP group.The result showed that there was no significant reduction in erectile function after operation in either group and there was no significant difference in both groups (P＞0.05).Conclusions Both PKRP and HoLEP shows effective and safe in the treatment of BPH.HoLEP provides more widely application range,especially in patients with some contraindications,less risk of haemorrhage,reduced bladder irrigation and catheter indwelling duration as well as reduced hospital stay.