Objectives: To assess the long-term clinical effectiveness, quality of life (QOL), bother, and satisfaction, using validated questionnaires, after transurethral resection of the prostate in patients with lower urinary tract symptoms due to benign prostatic enlargement. Methods: We enrolled men referred to a tertiary university hospital for further evaluation and treatment of lower urinary tract symptoms from January 1993 to September 1994 in a prospective cohort study. A total of 280 consecutive patients underwent transurethral resection of the prostate, mainly for outflow obstructive symptoms. They were recruited into this protocol-based study using validated self-reported questionnaires. The assessments included American Urological Association symptom score, flow rates, and measurement of QOL, bother, and satisfaction. The data were collected at baseline, 3 and 6 months, and 6 and 12 years of follow-up. Results: The mean QOL and bother score at baseline was 8.16 and 15.45, respectively. At 6 months, 6 years, and 12 years, the mean QOL and bother scores had improved to 2.54 and 4.84, 3.71 and 7.14, and 3.74 and 7.67, respectively. The improvements in the QOL and bother scores were consistent and statistically significant. Conclusions: Transurethral resection of the prostate not only proved to be clinically effective, but also improved patients' QOL and bother symptoms. This was associated with long-term, high patient-rated satisfaction.