Inclusion Criteria:  Patients with BPH who are unsatisfied with medical treatment having a Qmax of less than 15 cm/s. Patients with BPH who had refractory retention. Patients with complicated BPH (eg; chronic retention, refractory hematuria, bladder stones). Prostate size of at least 80 grams or more.  Exclusion Criteria:  Patients with a bladder mass. Patients with prostate cancer. Patients suffering from a urethral stricture. Patients with previous endoscopic or surgical prostate intervention. Prostate size less than 80 grams.