目的 观察并探讨经尿道钬激光前列腺剜除术（HoLEP）中保留部分尿道黏膜对尿控及性功 能的影响。方法 回顾性分析医院 2018 年 6 月至 2021 年 12 月就诊的 73 例前列腺增生患者资料，其中 39 例以保留部分尿道黏膜的 HoLEP 术治疗（改良组）；另 34 例以常规 HoLEP 术治疗（传统组）。比较两组患者术前与术后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、尿流率检测（Qmax）、残余尿（PVR）、前列腺特异性抗原（PSA）等指标变化情况；并观察两组患者术后尿失禁及性功能改变情况（逆行射精发生 率及 IIEF⁃5 评分）。结果 围手术期内两组患者血红蛋白下降值、手术时间、留置尿管时间、切除腺体质 量等指标差异无统计学意义（P > 0.05）。所有患者术后随访 12 个月，两组间 PSA、Qmax、IPSS、QOL 及 IIEF⁃5 比较差异无统计学意义（P > 0.05）；在短暂性尿失禁、逆行射精发生率的比较中，改良组明显优于 传统组（P < 0.05）。结果 改良 HoLEP 术式保留尿道黏膜不会增加手术风险，在达到同样疗效的情况下， 可以有效降低尿失禁及逆行射精的发生率，提高患者术后生活质量。 

Objective To analyze the effect of preservation of partial urethral mucosa on urinary conti⁃ nence and sexual function in holmium laser enucleation of the prostate（HoLEP）. Methods From June 2018 to December 2021，the data of 73 patients with benign prostatic hyperplasia in our hospital were retrospectively analyzed. Among them，39 patients were treated with the modified HoLEP，and the others were treated with classic HoLEP. The two groups of patients were compared in terms of post⁃void residual volume（PVR），prostate specific antigen（PSA），peak urinary flow rate（Qmax），international prostate symptom score（IPSS），and quality of life （QOL）. The changes in urinary incontinence and sexual function（incidence of retrograde ejaculation and interna⁃ tional index of erectile function score）were observed in the two groups after operation. Results There was no significant difference in the amount of postoperative hemoglobin decline，the average operation time，indwelling catheterization time and weight of resected glands（P > 0.05）. After 12 months，there was no significant difference in PSA，Qmax，IPSS，QOL and IIEF⁃5 between the two groups（P > 0.05）. The incidence of transient urinary incontinence and retrograde ejaculation in the modified group was significantly better than that in the classic group （P < 0.05）. Conclusion The modified HoLEP with urethral mucosa preservation does not increase the risk of operation. With the same efficacy，it can effectively reduce the incidence of urinary incontinence and retrograde ejaculation，and improve the quality of life of patients after surgery