Objective:To evaluate the efficacy and safety of holmium laser enucleation of prostate(HoLEP)by using en -bloc and bladder neck preservation technique and assess the influence on sexual functional outcomes. Methods:Retrospectively analyzed 209 patients who received HoLEP by en-bloc and bladder neck preservation technique from July 2016 to May 2020,and other 78 patients who received traditional transurethral resection of the prostate(TURP)as control. All patients had sexual activity and normal antegrade ejaculation before surgery. Results:The operation time and estimated blood loss in HoLEP group were less than those in the TURP group(P ˂ 0.05);The hospital stay and duration of catheterization in HoLEP group were slightly shorter than those in TURP group, but no significant(P > 0.05). There was no significant difference in complications between the two groups(P > 0.05). The immediate urinary incontinence rate in HoLEP group was significantly higher than that in TURP group(P ˂ 0.05). This trend was still manifested at 3 and 6 months,but gradually narrowed and converged at 12 months(P > 0.05). The international questionnaire score(IIEF-5)and erection hardness grading scale(EHGS)scores in both groups at 6 and 12 months after surgery were slightly improved(P > 0.05).There was no statistical difference in IIEF-5 and EHGS between the two groups before and 12 months after surgery(P > 0.05),and IIEF -5 and EHGS in HoLEP group at 12 months after surgery were higher than those in TURP group,but the difference was not statistically significant(P > 0.05). The incidence of retrograde ejaculation in HoLEP group was significantly lower than in the TURP group(P ˂ 0.05). Conclusions:HoLEP by an en - bloc and bladder neck preservation technique is small-injury and high -efficiency,especially reduce the occurrence of retrograde ejaculation.