Abstract: Objective To explore the efficacy of transurethral spiral thermo-expandable prostatic stent implantation and transurethral partial prostate resection for elderly patients with benign prostatic hyperplasia. Methods A total of 25 elderly (more than 75 years old) patients with benign prostatic hyperplasia were enrolled, who were admitted into Department of Urology, the Affiliated Hospital of Xuzhou Medical University from May 2017 to October 2018. Their clinical data and therapeutic effects were retrospectively analyzed. According to their surgical methods, they were divided into two groups (n=15): a prostate stent group and aPKRP group. Both groups were compared for the length of operation and hospitalization stay, as well as international prostate symptom score (IPSS), the max flow rate (MFR), residual urine volume (RUV), the visual analogue scale (VAS) score, and quality of life (QOL) before surgery and 3 and 12 months after surgery. Postoperative adverse reactions were collected during follow-up visits. Results After surgery, all the patients are able to urinate by themselves.Compared with the PKRP group, the stent group showed remarkably shortened length of operation(30.3±6.9) min vs(92.0±27.3)min and hospitalization stay(3.2 ±1.1) d vs (7.3 ±1.9) d, and reduced VAS scores (2.8 ±0.6) vs (4.2 ±1.2). After three months after operation, compared with the PKRP group, MFR was obviously improved in the stent group(13.8±2.0) ml·s^-1vs (15.2±1.6) ml·s^-1. There was no statistical difference in the changes of IPSS, RUV and QOL between the two groups. During follow-up visits one year after surgery, remarkable improvement was found in MFR, RUV and IPSS in the stent group (P<0.05). There were no serious complications such as prostate resection syndrome and stent displacement in the two groups. Conclusions The short-term efficacy of the two procedures is similar, and the stent is more effective at 1 year after surgery, and can be used as the first choice for patients with benign prostatic hyperplasia who cannot tolerate general anesthesia.