Ejaculation-Preserving Versus Standard Bipolar TUEP for BPH

This prospective randomized controlled trial will compare ejaculation-preserving bipolar transurethral enucleation of the prostate with standard bipolar transurethral enucleation of the prostate in sexually active men with benign prostatic hyperplasia and lower urinary tract symptoms after failed medical treatment. Participants will be randomly assigned to either ejaculation-preserving B-TUEP or standard B-TUEP. The study will evaluate preservation of ejaculatory function, erectile function, urinary symptom improvement, uroflowmetry outcomes, post-void residual urine, perioperative complications, and need for retreatment during follow-up.

Inclusion Criteria: * Male patients with lower urinary tract symptoms secondary to benign prostatic obstruction after failed medical treatment for at least 3 months. * Sexually active patients with a continuous relationship with the same partner. * International Prostate Symptom Score of 8 or greater. * Transrectal ultrasound-estimated prostate size between 40 and 100 cc. * Eligible for bipolar transurethral enucleation of the prostate. * Ability to complete the required sexual and urinary function questionnaires. * Ability to provide written informed consent. Exclusion Criteria: * Preoperative sexual dysfunction. * Preoperative ejaculatory dysfunction. * Diagnosis or suspicion of prostate cancer. * Neurological disorders affecting lower urinary tract or sexual function. * Detrusor hypocontractility. * Catheter-dependent patients. * Patients with bladder stones. * Inability or refusal to provide informed consent.