Multicenter Randomized Controlled Trial of ThuLEP Versus ThuLEP Combined With Bladder Neck Incision in Patients With Small-Volume Benign Prostatic Hyperplasia

Inclusion Criteria: * Male patients aged 50-85 years who meet the diagnostic criteria for benign prostatic hyperplasia (BPH), with a prostate volume ≤30 mL and requiring surgical intervention. * Preoperative International Prostate Symptom Score (IPSS) ≥8. * Preoperative maximum urinary flow rate (Qmax) ≤15 mL/s. * Bladder capacity ≥150 mL. * Willing to participate in this clinical trial and has signed the informed consent form. * Able to communicate well with investigators and comply with the study protocol requirements. Exclusion Criteria: * Patients with urethral stricture in whom passage of surgical instruments is not feasible. * Total PSA \>10 ng/mL, or PSA between 4-10 ng/mL with a free-to-total PSA ratio \<0.16, and confirmed malignancy on biopsy. * Coagulation disorders, including platelet count \<80 × 10⁹/L. * Uncontrolled urinary tract infection. * Neurogenic bladder. * Presence of malignant tumors. * Urodynamic diagnosis of bladder neck sclerosis, detrusor underactivity, detrusor-sphincter dyssynergia, or unstable bladder. * Contraindications to surgery, such as severe cardiopulmonary disease. * Cognitive impairment, including senile dementia, cerebral atrophy, acute cerebrovascular disease, sequelae of cerebrovascular disease, or other conditions affecting cognitive function. * History of suprapubic cystostomy for benign prostatic hyperplasia. * Acute localized or systemic bacterial infection that has not been effectively controlled. * Presence of shock or other critical conditions that preclude cooperation with the procedure and outcome evaluation. * Psychiatric or neurological disorders preventing cooperation with the study. * Participation in another clinical trial within 1 month prior to enrollment. * Any other condition deemed inappropriate for inclusion by the investigators.