The use of laser technology in the surgical treatment of patients with benign prostatic hyperplasia has recently become widespread and introduced into practice. This area of surgery uses a large range of laser modifications and methods of their application when performing surgical interventions on the prostate. The article discusses laser devices for minimally invasive operations on patients with benign prostatic hyperplasia in comparison with traditional methods of BPH surgical treatment. The advantages of using laser technologies include the reduction of the time of surgical intervention, the decrease in the number of traumatic complications and bleeding, the absence of the damaging effect of the shock wave, the possibility of using it with surgical instruments of the minimum diameter, and the possibility of using it with flexible surgical instruments.

The disadvantage of bipolar and holmium enucleation in transurethral surgery of benign prostatic hyperplasia (BPH) is the frequent postoperative urination disorders. To increase the effectiveness of surgical treatment, a modification of the surgical technique is necessary.Objective: to compare the perioperative results of endosurgical treatment of large sized BPH using transurethral bipolar (TUEB), laser (HoLEP) and modified laser prostate enucleation (HoLEP-M) methods. Patients and methods: A randomized prospective study was conducted according to the results of surgical treatment of 1104 patients with BPH with a volume of 80 to 350 cm3, divided by methods of endoscopic enucleation of the prostate. A mod-ification of the HoLEP technique was to optimize access to the surgical site with the designation of new anatomical landmarks.Results: Comparison of surgical methods showed their equivalence in the volume of removed tissue, the low frequency of hemorrhagic and infectious complications, the dynamics of urological indicators in the delayed period. TUEB has the least parameters for the time of surgical intervention (98.2 ± 2.24 min.), the vol-ume of blood loss (65.5 ± 1.83 ml), the terms of postoperative catheterization of the bladder (2.0 ± 0.32 days), and the days of hospitalization (3.2 ± 0.40 days). The safety of laser methods is higher than TUEB, during which 3.1% of closed perforations of the prostatic capsule and bladder were observed (versus 0.8-1.5% with laser methods). Modification of the HoLEP technique allows reducing the frequency of late dysuric disorders by 2-3 times, urinary incontinence by 3.4-4 times, cicatricial complications by 1.7-2 times.Conclusion: Bipolar and laser methods of transurethral enucleation of the prostate of large sizes are comparable by criteria of complete removal of prostatic tissue, effectiveness and tolerability in patients with thrombohemorrhagic risk. In terms of the frequency of intraoperative injuries, the safety of laser methods is higher due to the reduced penetrating ability of laser energy. Modification of surgical access to the prostate preserves the prostatic urethra as much as possible and is a promising measure for the prevention of late obstructive and functional complications of transurethral interventions.

The article presented an overview of literary sources, which include a description of various surgical techniques for the treatment of benign prostatic hyperplasia in different historical periods. The assessment of the disadvantages and advantages of various surgical methods for the treatment of benign prostatic hyperplasia has been made. Modification and improvement of surgical interventions, changes in methods and approaches to surgical treatment of benign prostatic hyperplasia made the surgeon’s work more accessible and of high quality. The development of surgical methods of treatment has made it possible to increase the efficiency of surgical interventions, which, in turn, has a positive effect on the quality of life of urological patients.