ABSTRACT Background: To evaluate the 10-year functional outcomes (primary) and frequency and predictors of BPH surgical retreatment (secondary) after ThuLEP. Materials and Methods: A single-center retrospective analysis of consecutive patients undergoing ThuLEP between 2010 and 2013 was performed. Inclusion criteria were: age ≥ 40 years, prostate volume (PV) ≥ 80 mL, International Prostate Symptom Score (IPSS)-Total score ≥ 8 points. IPSS-Total score was the primary outcome, and BPH surgical retreatment rate was the secondary outcome. Paired t-test, McNemar test, and Wilcoxon signed-rank test were used to compare variables. Logistic regression analysis was performed to evaluate predictors of surgical retreatment. Results: A total of 410 patients with a mean ±SD age of 63.9 ± 9.7 years and a PV of 115.6 ± 28.6 mL were included. Mean ±SD follow-up was 108.2 ± 29.6 months. IPSS-Total score was significantly improved at 1 year compared to baseline (23.3 ± 4.7 vs. 10.3 ± 3.8; p<0.001). It was similar after 5 years (10.5 ± 3.6 vs. 10.7 ± 5.0; p=0.161), with a significant worsening at 10 years (10.3 ±4.8 vs. 13.8 ±4.5; p=0.042) but remaining statistically and clinically better than baseline (13.8 ±4.5 vs. 22.1 ±4.3; p<0.001). After 10 years, 21 (5.9%) patients had undergone BPH reoperation. Baseline PV (adjusted OR 1.27, 95% CI 1.09-1.41; p<0.001) and time from BPH surgery (adjusted OR 1.32, 95% CI 1.15-1.43; p<0.001) were predictors of BPH surgical retreatment. Conclusions: ThuLEP is associated with optimal functional outcomes and a low frequency of BPH surgical retreatment in the long-term. Baseline PV and time from surgery were predictors of BPH reoperation. Background 10year (primary (secondary Methods singlecenter single center 201 4 (PV IPSSTotal IPSS Total points outcome ttest, ttest t t-test signedrank signed rank variables Results 41 SD 639 63 9 63. 97 7 9. 1156 115 6 115. 286 28 28. included followup follow up 1082 108 2 108. 296 29 29. months 23.3 233 23 3 (23. 47 4. vs 103 10. 3.8 38 p<0.001. p0001 p p<0.001 . 0 001 10.5 105 (10. 36 3. 107 5.0 50 p=0.161, p0161 p=0.161 , 161 p=0.161) 48 ±4. 138 13 13. 45 p=0.042 p0042 042 (13. 221 22 22. ±4.3 43 5.9% 59 (5.9% reoperation adjusted 127 27 1.27 95 1.091.41 109141 1.09 1.41 09 1.09-1.41 132 32 1.32 1.151.43 115143 1.15 1.43 15 1.15-1.43 Conclusions longterm. longterm long term. term long-term 20 11 23. (23 p000 p<0.00 00 (10 5. p016 p=0.16 16 ±4 p=0.04 p004 04 (13 5.9 (5.9 12 1.2 091 1.091.4 10914 109 1.0 141 1.4 1.09-1.4 1.3 151 1.151.4 11514 1.1 143 1.15-1.4 (2 p00 p<0.0 (1 p01 p=0.1 p=0.0 (5. 1. 1.091. 1091 14 1.09-1. 1.151. 1151 1.15-1. ( p0 p<0. p=0. (5 1.091 1.09-1 1.151 1.15-1 p<0 p=0 1.09- 1.15- p< p=