My experience with the two drugs, tamsulosin and finasteride was mixed. I was on them for about 2 years, ostensibly (I don't know for sure if they worked, but I will assume so per my urologist), to decrease prostate size and open the urethra. They did seem to somewhat help in my overall ability to urinate. However, if I did not urinate when I had the urge (e.g. on a road trip without easy access to a bathroom), I still had painful episodes of not being able to urinate until after several (very minimal, drippy at best) tries. Usually, I could almost empty my bladder after an hour or two. However, they caused a troubling decrease in libido, increased ED, and internal ejaculations 100% of the time. What has caused me the worst problems with not being able to urinate due to BPH since 2010 was having surgery with anesthesia. This began with the first hip replacement in 2010, then 2nd in 2011. After my first shoulder joint replacement in 2020, I began taking the 2 meds; meds were increased after 2nd shoulder joint replacement in 2022...after which I was on a catheter for several days. I had a hernia surgery with anesthesia in February 2024, and could not urinate at all afterwards...had to go to the ER to get catheterized a day after hernia surgery. So, prostate surgery was the only answer. I was on a catheter from February 14 to May 16 2024. Horrible. I had Aquablation surgery on 4/29/24...and the results, for me...have been phenomenal. I wish I had had it sooner. All BPH symptoms are gone...I haven't had such a good urine stream in decades. My libido and ED are much improved, and ejaculations, though nothing like when I was younger (I'm 73) are again all external. Aquablation was wonderful for me.