الفهرس 
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Abstract
Introduction:. HoLEP whenever available, has established its position as the current gold standard treatment for large sized BPH. Other minimally invasive surgical MIS contenders are resection in saline and high power laser vaporization of the prostate namely Greenlight laser (532nm laser). The aim of work: In this study we tested the Greenlight (532-nm) laser Photoselective Vapo-Enucleation of the Prostate (GL PVEP) using (XPS) 180W system and bipolar transurethral resection of the prostate (TURis) in comparison to Holmium Laser Enucleation of the Prostate (HoLEP) in reduction of LUTS secondary to large sized BPH in a prospective randomized trial. Research Plan: Patients with LUTS due to BPH who were meeting the study inclusion criteria (TRUS volume from 80 to 150 ml) were randomized between GL PVEP (60 patients), HoLEP (60 patients) and TURis (62 patients). Perioperative variables were reported and compared. Patients were followed at 1, 4 and 12 months postoperative. Results: The mean IPSS at 12 months was comparable median 4 (1-29), 3 (0-15) and 3 (0-30) in in GL PVEP, HoLEP and TURis groups respectively which is non-significant between the two groups. Postoperative 12 months postoperative median percent reduction of PSA level was significantly higher post HoLEP procedures 88.5% (5:98), compared to GL PVEP and TURis, 62.7% (-76:95) and 68.7% (-30:96) respectively (P=0.000). Re-intervention and persistent incontinence were not significant between the three groups. Conclusion:.Despite enucleation technique using holmium laser is the gold standard in the treatment of large sized BPH larger than 80 ml, resection using bipolar energy and vapo-enucleation using green light laser remain feasible options in the treatment of large prostate (80-150 ml).