Elderly patients with prostatic hyperplasia (BPH) have increased abdominal pressure due to long-term urinary difficulties, while their own abdominal wall muscles are atrophied and the tissue structure is relaxed, which further reduces the strength of the abdominal wall, so patients with BPH are prone to complications of inguinal hernia. About 5% to 12% of people with BPH requiring surgical treatment also have inguinal hernia. Prostatectomy and hernia repair should be performed concurrently in elderly patients with inguinal hernia with BPH, which can eliminate the recurrence of hernia due to urinary difficulties. Compared with open surgery, TUVP has the advantages of less injury and faster postoperative recovery, and is considered the first choice for simultaneous surgery. The plasma vaporization electrosurgery (PKVP) is a low-temperature cut compared to the common prostate electrosurgery (TUVP), which has a small heat penetration, reduces tissue scarring, is conducive to epithelial regeneration, is less irritating to the urinary bladder, and has a faster postoperative recovery; flushing with physiological saline effectively prevents the occurrence of electrosurgery syndrome, and the operating time is not limited to ensure the amount of resection, which is more beneficial to diabetic patients. No negative circuit board is required, which prevents electric shock and burns. When transurethral prostatic pneumoneurotomy and inguinal hernia repair are performed at the same time, hernia repair should be performed before TUVP or PKVP, because hernia repair has fewer accidents and complications than TUVP or PKVP, and the operation can be ended immediately if accidents and complications occur during TUVP or PKVP. Adhering to the hernia surgical area will avoid wetting or contaminating the incision dressing. Continuous postoperative bladder irrigation to keep the catheter open and treat any obstruction immediately. Symptomatic management of increased abdominal pressure conditions such as bladder spasm, cough and constipation is also essential to ensure successful surgery. Simultaneous TUVP or PKVP and inguinal hernia repair is simple and efficacious, and also has the advantages of less trauma, shorter operative time, faster postoperative recovery, shorter hospital stay, and avoidance of secondary surgical pain.