Abstract：Objective To investigate the urinary control and ejaculation function protection of McNeal band laser enucleation and vaporization in patients with anterior moderate to severe benign prostatic hyperplasia （BPH）. Methods Using a prospective, single-centre study, a total of 174 patients with moderate-to-severe BPH treated with M-TULIP admitted to our hospital from January 2019 to December 2021 were used as the experimental group, and 154 patients with BPH treated with transurethral plasma enucleation of prostate （TURP） were used as the control group. The patients were subdivided into 99 patients in the experimental group with moderate hyperplasia （EM group）, 94 patients in the control group with moderate hyperplasia （CM group）, 75 patients in the experimental group with severe hyperplasia （EL group） and 60 patients in the control group with severe hyperplasia （CL group） according to the preoperative estimated prostate volume. The four groups were compared in terms of perioperative related indicators, glandular resection rate, incidence of postoperative complications, incidence of erectile dysfunction （ED） and ejaculatory dysfunction （EjD）, as well as preoperative and post-operative scores on each evaluation scale, maximum urinary flow rate （Qmax）, and residual urine volume （PVR）. Results The differences were statistically significant when comparing the perioperative related indexes and glandular resection rates between the EM and CM groups, EL and CL groups, EM and EL groups, and CM and CL groups （all P＜ 0.05）; the complication rates in the EM group were lower than those in the CM group, and those in the EL group were lower than those in the CL group, and the differences between the groups were statistically significant （χ2＝3.888,6.371，all P＜0.05）. The incidence of ED and EjD in the experimental group were significantly lower than that in the control group, and the difference between the groups was statistically significant （χ2＝66.024、 165.270, all P＜0.05）; postoperative Qmax, International Prostate Symptom Score （IPSS）, Quality of Life Score （QoL）, and PVR indexes in the experimental and control groups were all improved significantly compared with those before surgery; the differences in IIEF-5 scores and CIPE scores after surgery in the EM and EL groups were not statistically significant when compared with those before surgery （all P＞0.05）; the differences in IIEF-5 scores and CIPE scores after surgery in the EM and CM groups and in the EL and CL groups were statistically significant （t＝12.351, 27.008, 6.167, 21.748, all P＜0.05）.  Conclusion M-TULIP has essentially equivalent surgical efficacy to TURP. However, M-TULIP has a lower tissue resection rate, better operative time, intraoperative bleeding, hospital stay and indwelling urethral catheter than TURP, and the incidence of postoperative urinary incontinence, EjD, ED and urethral stricture is significantly lower than that of TURP. Therefore, for patients with moderate to severe BHP, it is not necessary to pursue a higher resection ratio and resection weight. M-TULIP has clinical application advantages and is worth promoting.