Objective: To investigate the clinical efficacy of predictive nursing integrated with comfort care in the postoperative recovery of patients undergoing transurethral plasma kinetic resection of the prostate (TUPKRP) under the framework of the Enhanced Recovery After Surgery (ERAS) concept, and to provide evidence-based reference for optimizing perioperative nursing protocols in clinical practice. Methods: A total of 120 patients with benign prostatic hyperplasia (BPH) who underwent TUPKRP from April 2023 to March 2025 were selected as research subjects. They were randomly divided into a control group (n=60) and an observation group (n=60). The control group received conventional perioperative nursing, while the observation group received predictive nursing combined with comfort nursing guided by ERAS principles. The postoperative complication rate, recovery indicators, pain Visual Analogue Scale (VAS) scores, comfort level (Kolcaba's Comfort Questionnaire, GCQ), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and nursing satisfaction were compared between the two groups. Results: The overall complication rate in the observation group (5.00%) was significantly lower than that in the control group (20.00%), with a statistically significant difference (P<0.05). The observation group had shorter catheter retention time, bladder irrigation time, and hospital stay, and lower International Prostate Symptom Score (IPSS) compared to the control group, with statistically significant differences (P<0.05). On postoperative days 1, 3, 5, and 7, the VAS scores of the observation group were lower than those of the control group, with statistically significant differences (P<0.05). At 24, 48, and 72 hours postoperative, the GCQ scores of the observation group were higher than those of the control group, with statistically significant differences (P<0.05). After the intervention, the PSQI scores in all dimensions (sleep quality, sleep onset time, sleep time, sleep efficiency, sleep disturbances, use of sleeping medications, daytime dysfunction) were lower in the observation group compared to the control group, with statistically significant differences (P<0.05). The nursing satisfaction in the observation group (95.00%) was higher than that in the control group (80.00%), with a statistically significant difference (P<0.05). Conclusion: Predictive nursing combined with comfort nursing under the guidance of ERAS principles can significantly reduce the postoperative complication rate in TUPKRP patients, shorten recovery time, relieve pain, improve comfort and sleep quality, and increase nursing satisfaction. This approach is worth promoting in clinical practice.