Objective To explore the effect of dexmedetomidine on preventing the delirium and restlessness after transurethral electroprostatectomy, and its influence on reproductive hormones. Methods 168 cases of men patients underwent the transurethral resection of prostate in our hospital were selected as the research object from January 2017 and December 2018, and randomly divided into the control group (n=84) and observation group (n=84) according to the number table method. Control group was postoperatively treated PICA with the routine sufentanil and propofol analgesic therapy. While, the observation group was given the dexmedetomidine based on the control group therapy. The visual analogue scale (VAS) and Ramsay sedation score method were used to evaluate patients’ pain degree and calm after surgery. Meanwhile, the delirium rating method (CAM) assessment was also obtained postoperative delirium occurrence 1, 2, 3 days. Serum reproductive hormone levels were detected by ELISA at the same time. Results After the 2, 8, 12, 24 h of surgery, VAS score of patients in the observation group were lower than that in the control group. Especially, VAS score after 12 h presented statistical difference between the two groups (P0.05). Ramesay scoring results showed that scores of patients in the observation group postoperative 2, 8, 12 h were significantly lower than that of the control group (P0.05), but the Ramesay score after 24 h surgery had no statistical difference (P0.05). The total delirium incidence within 3 d in the observation group was 3.57%, significantly lower than that 11.90% in the control group with statistically significant difference (P0.05). After surgery of 24 h, serum T and E2 levels of the observation group were significantly higher than that of the control group, the difference was statistically significant (P0.05). While, other reproductive hormones FSH, LH levels presented no statistically significant difference compared with control group (P0.05). After 1 week, serum reproductive hormone levels of two groups were significantly higher than that after surgery 24 h (P0.05). Conclusion After transurethral electroprostatectomy, dexmedeidine has a significant analgesic and sedative effects, which could indirectly romote the gonad function resumed as soon as possible and help the early recovery.