Green LEP vs ThuLEP in Management of Marked Enlarged Prostate

Inclusion Criteria: * Patients' age ≥ 40 years * LUTS secondary to BOO due to BPH who failed medical treatment * International prostate symptom scores (IPSS) \>15 and bother score (QOL) ≥ 3 (according to IPSS question 8) * Peak urinary flow rate (Qmax) \<15 ml/sec with at least 125 ml voided volume or Patients with acute urine retention secondary to BPH who failed trial of voiding on medical treatment. * ASA (American society of anaesthesiologists) score ≤3. * TRUS prostate size \> /= 80 ml Exclusion Criteria: * Patient with neurological disorder which might affect bladder function as cerebrovascular stroke, Parkinson disease * Active urinary tract infection, * Presence of active bladder cancer (within the last 2 years) * Known prostate cancer patients will be excluded preoperatively on the basis of digital rectal examination, prostate specific antigen level, and TRUS imaging followed by prostate biopsies if necessary. * Patient has a disorder of the coagulation cascade (e.g., liver cell failure) or disorders that affect platelet count or function (e.g., von Willebrand disease) that would put the subject at risk for intraoperative or postoperative bleeding. * Patient is unable to discontinue anticoagulant and antiplatelet therapy preoperatively (3-5 d) except for low-dose aspirin (e.g., 100 mg). * Patient has had an acute myocardial infarction or open-heart surgery \<180 days prior to the date of informed consent.