Basing on the results obtained in 380 patients, the efficacy of radical surgery of prostatic adenoma was studied in 3 groups of patients: group 1 (136 patients) underwent urgent adenomectomy because of acute urine retention; group 2 (153 patients) with severe concomitant diseases underwent one or two-stage adenomectomy; group 3 (92 patients) without clinically manifested somatic pathology. The author shows practical significance of urgent (within 72 hours) and delayed (within 5-10 days) radical adenomectomies in surgery of patients with acute urine retention. Long-term preoperative therapy of circulatory disorders and diabetes mellitus allowed performance of radical adenomectomy in additional 20-30% of group 2 patients. Positive outcomes were achieved in 88.2%, 80.4%, 93.4% of patients from groups 1, 2 and 3, respectively. Urination recovered in 98.5% of those operated on. Hospital lethality was 9.7%. Its cause was mainly purulent pyelonephritis (70.3%), the rest lethal outcomes occurred due to circulatory, respiratory and gastrointestinal diseases.