目的 探讨保留部分尿道黏膜改良钬激光前列腺剜除术（改良 HoLEP）治疗良性前列腺增 生（BPH）的先进性和有效性。方法 选取 180 例 BPH 患者，随机分为 A、B、C 三组，每组 60 例。A 组行 改良 HoLEP，B 组行传统 HoLEP，C 组行经尿道前列腺电切（TURP）。比较三组患者围手术期相关指标， 术后随访指标及并发症发生情况。结果 三组患者基线资料差异无统计学意义（P > 0.05）。在手术时 间、切除效率上，改良 HoLEP 组优于传统 HoLEP 组及 TURP 组（均 P < 0.05）。在术后膀胱冲洗时间、保留 导尿时间、组织切除量及术中出血量上，改良 HoLEP 组与传统 HoLEP 组差异无统计学意义（P > 0.05）， 但均显著优于 TURP 组（P < 0.01）。改良 HoLEP 组拔管后尿失禁发生率（6.7%）明显低于传统 HoLEP 组 （23.3%），差异有统计学意义（P < 0.05）。三组患者术后 6 个月最大尿流率、残余尿量、国际前列腺症状 评分及生活质量量表评分均较术前显著改善（均 P < 0.01）。结论 传统 HoLEP 相较 TURP 腺体剜除率 高，术中出血少，术后恢复快，改良 HoLEP 在此基础上进一步降低手术难度，提高剜除效率，明显减少术 后尿失禁发生率，更具优势。

Objective To investigate the efficacy and advantage of modified holmium laser enucleation of the prostate（HoLEP）with preservation of partial urethral mucosa in the treatment of benign prostatic hyperplasia （BPH）. Methods 180 patients diagnosed with BPH were enrolled in the study. They were randomly divided into three groups，A，B and C，with 60 patients in each group. Group A received modified HoLEP，group B received conventional HoLEP，and group C received transurethral resection of the prostate（TURP）. Clinical data of preoper⁃ ative，intraoperative and postoperative follow ⁃up were recorded and compared. Results There was no significant difference in the preoperative baseline characteristics among the three groups（P > 0.05）. In terms of operation time and tissue resection efficiency，the modified HoLEP group was superior than the conventional HoLEP group and TURP group（all P < 0.05）. There was no significant difference between the modified HoLEP group and the conventional HoLEP group in bladder irrigation time，indwelling catheter time，the amount of tissue resection and intraoperative blood loss（all P > 0.05），but they were both superior than those of TURP group（P < 0.01）. The incidence of postoperative urinary incontinence in the modified HoLEP group（6.7%）was significantly lower than the conventional HoLEP group（23.3%）（P < 0.05）. Over the follow⁃up period of 6 months，the maximum urinary flow rate，post⁃vociding residual，international prostate symptom score and quality of life score were significantly improved（all P < 0.01）. Conclusion Compared with TURP，conventional HoLEP has low gland residue rate， less intraoperative blood loss and faster postoperative recovery. Modified HoLEP can further improve the enucle⁃ ation efficiency and reduce the incidence of urinary incontinence after operation. Therefore，modified HoLEP is superior for the treatment of BPH and worthy of promotion.