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Objective: To evaluate plasmakinetic vapor enucleation of the prostate (PVEP) with button electrode and plasmakinetic resection of the prostate (PKRP) in patients with urinary symptoms due to benign prostatic enlargement (BPE)>90ml.Methods: A total of 112 patients with symptomatic BPE were randomly assigned to either PKRP or PVEP prospectively from August 2012 to May 2014 in our department.Perioperative and postoperative data were investigated during a 3-month fo llowup.Results: PVEP was significantly superior to PKRP in terms of operation time (63.9±7.7 mins vs 78.1±13.6 mins, p<0.001), hemoglobin loss (1.18±0.30 g/dl vs 1.63±0.38 g/dl, p<0.001), serum sodium decrease (2.9±0.7 mmol/1 vs 4.3±0.8mmol/l, p<0.001), catheterization duration (49.3±12.2 hours vs 78.1±14.8 hours, p <0.001) and hospital stay (100.2±28.3 hours vs 116.0±29.2 hours, p=0.004).There were no statistical differences in blood transfusion between two groups.In addition, there were no statistical differences in maximum urinary flow rate, International Prostate Symptom Score, post-void residual urine volume, quality of life score, transient incontinence and urethral stricture at 3 months postoperatively.Conclusions: PVEP with button electrode is an equally effective technique for treatment of large BPE with PKRP, with more safety and faster recovery.It may become the superior alternative to PKRP for patients with large BP E.