To evaluate outcomes of transurethral bipolar enucleation (TuBE) of the prostate in patients with refractory lower urinary tract symptoms. A retrospective analysis was performed on patients who underwent TuBE from July 2014 to March 2015. Perioperative factors evaluated included International Prostate Symptom Score, Sexual Health Inventory for Men score, prostate-specific antigen, postvoid residual volume, transrectal ultrasound volume measurement, estimated blood loss, operative time, pathologic weight, and complications. Postoperative evaluation was performed at 6 weeks and 3 months. Forty-nine patients were identified. Mean age was 67 years and mean follow-up was 4.4 months. Twenty-eight patients (57%) were in retention. Preoperative, 6-week, and 3-month mean postvoid residual volumes were 278 mL, 66 mL, and 87 mL (P < .01); mean International Prostate Symptom Scores were 22, 9, and 8 (P < .01); mean quality of life scores were 5.0, 1.9, and 1.9; and Sexual Health Inventory for Men scores were 7.1, 8.4, and 7.0 (P = .35), respectively. Twenty-eight patients (57%) were able to have erections preoperatively and were still able to postoperatively. All (100%) of the patients in retention were able to void postoperatively. Mean operative time was 93 minutes, estimated blood loss was 49 mL, and pathologic weight was 18 g. Urinary tract infection occurred in 3 patients (6%), urethral stricture in 1 (2%), and bladder neck contracture in 2 (4%). Mean prostate-specific antigen decreased from 3.2 ng/dL to 0.9 ng/dL at 3 months (P < .01). TuBE is an effective operation for refractory urinary tract symptoms including those who are in urinary retention.