The incidence of prostate enlargement is increasing and is now the most common urological condition. Many patients with prostate enlargement are of advanced age and have combined multisystem diseases. If a patient with prostate enlargement is older than 80 years old or has more than one serious lesion or damage to an important organ or system, he or she may fall into the category of high-risk prostate enlargement. As the special systemic and local physiological and pathological changes in high-risk prostate enlargement patients increase the risk of treatment, how to carry out treatment has become a difficult clinical work. The conservative treatment such as drugs is inaccurate and not ideal. Long-term indwelling catheterization or suprapubic cystostomy violates the natural physiological process of urination and requires regular replacement of the catheterization device, which is prone to complications such as urinary tract infection, bleeding, bladder stones, etc. The quality of life of patients is seriously reduced. At present, transurethral resection of prostatic hyperplasia (TURP) is still recognized as the “gold standard” for the treatment of prostatic hyperplasia, but its biggest drawback is the high intraoperative bleeding and the possibility of complications such as transurethral resection syndrome (TURS), which makes it a risky procedure to treat high-risk prostate hyperplasia patients. The current widely used transurethral electrical vaporization of prostatic hyperplasia (TUVP) partially compensates for the defects of TURP in terms of intraoperative hemostasis and broadens the surgical indications, but the possibility of TURS still cannot be avoided because of the unclear vaporization level and the tendency to cut through the peritoneum and the use of crystal-free medium for irrigation, and it has deep thermal penetration and is often accompanied by certain thermal damage to the surrounding tissues, such as closed nerve The complications such as reflexes, extraprostatic nerve damage outside the prostate envelope, and electrostatic damage to the external urethra have limited its application in the treatment of high-risk prostate enlargement. In 1998, the British company Gyrus developed the plasma bipolar vaporization cutting system, which has both a working electrode and a loop electrode, and the working electrode and the loop electrode generate a loop and release radiofrequency energy, which transforms the conductor medium (saline) into a highly focused plasma area around the electrode. These high speed ionized particles have enough energy to break the molecular bonds of the target organic tissue and as a result, the target tissue is fused into basic molecules and then broken. This technology applied in clinical treatment of prostate enlargement has unique advantages compared with TURP and TUVP: ① Using saline as the working medium, even though saline enters the body, it has little interference with the patient’s internal environment, effectively avoiding the occurrence of TURS. ② Low temperature cutting, the cutting temperature is only between 40~70℃ , the thermal effect is small, the thermal injury is small, it can avoid the closed nerve reflex, damage to the external urethral sphincter and the prostatic extra perineal sexual nerve. The vaporization of the surface tissue when cutting the prostate tissue and the formation of a 2~3mm uniform coagulation layer under the vaporization level can cause occlusion of small arteries, veins and capillaries in the cross-section, so that intraoperative hemostasis is exact and reliable. The cut surface is flat and smooth, and the amount of fluid absorbed is low, so there is no need to pay much attention to the length of the operation, and the operation can be carried out as planned. The weight of the prostate tissue cut is significantly increased, and even larger prostate hyperplasia tissue can be completely removed. The plasma bipolar vaporization cutting system has the ability to identify tissues with different impedance, resulting in a feeling of coagulation or ineffective cutting when replacing the cut wound, and to a certain extent can avoid damage to the prostate envelope and bladder neck. TUPKVP has a low chance of TURS, but with the prolongation of the operation, some of the fluid inevitably enters the body through the surgical wound, increasing the patient’s cardiovascular load, which may lead to a series of pathophysiological changes in the body and increase the risk of surgery. Therefore, the operation time should be controlled within 70 minutes as much as possible, and it is not necessary to force a complete and perfect removal of all the enlarged prostate tissue for those with huge prostates. Postoperative bleeding is the main complication of TUPKVP and should be taken seriously. In two cases in this group, secondary bleeding occurred 1 week after surgery, and the bleeding was controlled by flushing out the clot in the bladder via cystoscopy, leaving the catheter in place, traction on the catheter so that the balloon was compressed at the bladder neck opening, and continuous bladder irrigation. Postoperative epidural injection of small dose morphine or self-administered analgesic technique can be given to prevent bladder spasm, give the necessary laxative to prevent constipation, strengthen anti-infection treatment, chronic liver disease, hepatic insufficiency often have coagulation mechanism disorders, should be given appropriate vitamin K, hemostatic aromatic acid and other drugs to prevent secondary postoperative bleeding. Postoperative care should be strengthened, especially attention should be paid to abnormal changes in the circulatory and respiratory systems to enable patients to safely pass the perioperative period. In conclusion, TUPKVP has obvious safety and effectiveness compared with other treatment methods in the treatment of prostatic hyperplasia and is worthy of wide application.